An accurate weight can help save a life

Obtaining accurate patient weight — especially for immobile patients — is a global problem. While safe practice protocols tell us an accurate weight measurement is important to avoid adverse drug events and ensure effective patient care, in practice it’s difficult and time consuming to achieve.

There have been numerous studies both in Australia and internationally that identify the difficulties in accurately weighing patients. These include inability to access appropriate weighing equipment, clinical status — including physical or cognitive impairment, time — with hoist weighing taking up to 20 minutes per patient and perceptions that weighing patients is invasive.

In fact, nurses rank lifting and weighing patients among their 8 most stressful handling tasks. No wonder medical staff estimate a patient’s weight or ask the patient what they weigh.

The Australian Commission on Safety and Quality in Healthcare recommends weighing all patients on admission to hospital. It also recommends ongoing weekly (for acute patients), monthly (for other streams) weighing and/or when a patient’s condition changes. Timely and accurate patient weight informs a variety of patient interventions which include, safe prescribing practices, radiation and chemotherapies, manual handling, skin integrity management and identifying nutritional risk.

Yet data collected from Australian hospitals identifies a widespread problem with obtaining and recording accurate patient weight.

While suboptimal, the general practice is to visually estimate patient weight. Studies (Menon S, Kelly AM) found medical personnel all inaccurately estimated patient weight with an error rate ranging between 7.7 and 11%. In fact, only 59% of physicians made weight estimates to within 10% of actual weight. Even when asked to provide their own weight, patients provided inaccurate information with an error rate of 3.9%.

Frustrated by the difficulties of gaining accurate patient weight and its importance to determine dosage, former UK emergency department nurse, Gillian Taylor, decided the weighing process had to change. So, with help from UK scale manufacturers, Marsden, Gillian developed the Patient Transfer Scale.

Using the existing process of transferring a patient from trolley to bed or bed to bed, the Patient Transfer Scale quickly and accurately measures a patient’s weight. When asked why she designed the Patient Transfer Scale, Gillian said:

“With some medicines, there’s a narrow window for them to be given, but weighing a patient can take quite a bit of time. While for illnesses like sepsis or strokes, it’s vital to get an accurate weight for safe medication management. One day I thought, why can’t we have a full-body sliding board with a built-in scale so we can weigh patients during the transfer process?”

In hindsight, it’s such a simple idea but it took an experienced ED nurse to come up with it. With the Patient Transfer Scale, weighing patients becomes part of the existing lateral transfer process as a patient is transferred from trolley to trolley, trolley to bed or bed to bed.

The Patient Transfer Scale has been tested in 30 different hospitals to address a wide range of medical environments and requirements. It provides highly accurate weight measurements at 500g increments and can handle obese patients with a capacity of 250kg. It measures 1800mm x 510mm in size. Importantly, the Patient Transfer Scale is TGA Registered.

Obviously, there are many factors that contribute to patient outcomes, but accurate weighing is significant. The correct dosage of treatments is often dependent on exact weight. With some, underestimating a patient’s weight can cause toxicity while overestimating a patient’s weight can lead to suboptimal therapeutic effects.

Door to needle time is another factor that affects patient outcomes — especially for critical care patients. Globally door to needle (DTN) time policies range from 210 minutes in Bangladesh to 19 minutes in Japan with the average being 30 minutes. Yet these targets are consistently difficult to meet. In a recent study of 178 US hospitals, only 44.5% of patients were thrombolysed within the target time.

When the Patient Transfer Scale is introduced, many hospitals find the speed and ease of weighing patients, along with the associated improvement in door to needle times and dosage accuracy, are helping to ease nursing workloads, improve patient outcomes and relieve some of the pressure on hospital systems.

The Patient Transfer Scale recently arrived in Australia. To arrange a demonstration to investigate how easily it will fit into your existing lateral transfer processes, contact Australia’s exclusive suppliers, Wedderburn.

Image caption: Gillian Taylor, Inventor of the Patient Transfer Scale