Nursing Practice and Immobility Reference
Mobility
Body mechanics
Co-ordinated efforts of
muscular / skeletal system to maintain, balance posture and body alignment during lifting, bending, moving and performing activities of daily living. Good body mechanics Crisp, J. and Taylor, C. (2009) Potter & Perrys fundamental s of nursing. 3rd edition. Chatswood: Elsevier.
reduces the risk of injury for nurses Key Terms
and patients Alignment
abduction adduction body alignment base of support body mechanics dorsal (supine) dorsal recumbent dorsiflexion extension flexion hyperextension immobility joint mobility orthopnoeic pronation prone range-of-motion (ROM) semi-Fowlers position Sims position supination
-good alignment (or straight / proper anatomical positioning) is important when standing sitting or lying -helps to reduce injury for nurses
and patients. Balance
Balance control means the
centre of gravity is appropriate for the task at hand Balance is best with -a wide base of support -low centre of gravity kept in the base of support Gravity and friction
The weight of an object
person is the force exerted from gravity
Friction occurs when two
Principles of body mechanics
surfaces rub against another Movement of the human body What do we know? system, muscles. Mobility and immobility skeletal
Body mechanics Alignment Balance Gravity and friction
Mobility is the ability to -advantages of mobility include:
can prevent further pain, suffering and complications Assessment of immobility Include Range of motion (ROM) of joints * Gait (style of walking) Exercise and activity tolerance Body alignment ROM of a joint *
move freely
Exercise and movement has been shown to have positive outcomes for all major systems of the body (p1278) Immobility is.. Impaired physical mobility may impact on all systems of the body Complications of Immobility
Joints -flexion -extension -rotation -abduction / adduction -pivotal
Metabolic changes Respiratory changes Cardiovascular changes Musculoskeletal changes Urinary elimination changes Integumentary changes include:
Nursing Interventions to reduce the impact of immobility Individualised for each Range-of-motion (ROM) -(active patient independently or passive nurse moves each joint) -minimum 2-3 times each day
patient
Complications of immobility muscle and bone atrophy contractures pressure ulcers constipation UTI (urinary tract infection) postural hypotension anorexia insomnia Asthenia disorientation
exercises
Reposition regularly Ambulation : regular and Good nutrition * Adequate fluid intake Monitor elimination Assess skin integrity Monitor sleep Ensure stimulation Use of aids e.g. gait belt Promote independence
ensuring good body alignment,
safe
Nurses knowledge Knowledge about the impact
of immobility on patients and the use of interventions aimed to counteract the effects of immobility
Working with patients
-physical limitations, stress and fatigue Lite
It is essential that nurses use
good body mechanics when working with patients.
Task What has to be done, how
Good body mechanics
and when - steps involved, a nominated leader, do I need equipment, can the patient help Lite Environment
reduces the risk of injury for nurses Background Information
Nurses have one of the
highest incidences of any occupational group for workrelated, musculoskeletal injuries
The working environment -facilities, staffing levels, culture and resources
In 1999, ACC claims by
nurses cost more than $30 Million dollars Background Information
Maximum Limits 16 kg limit Note: Not safety limits Males: 25 kilos Females: 16.6 kilos But..only when..
New Zealand Patient
Handling Guidelines (2003) LITEN UP and REDUCE THE RISK LITE
Handling done in a suitable Carers maintain good Load is held close to the
L oad I ndividual T ask E nvironment Characteristics that can Includes: age, gender, diagnosis, neurological status, size, weight, ability to co-operate and risk of falls, surgical limitations, sin condition -ability to hear and see
environment
posture
Lite Load
mid-body range between elbow and knuckle height Limits drop significantly in other positions! Putting it all together
affect the handling risk:
Whenever you work with a Introduce yourself Assess all aspects of LITE Collect equipment and Request assistance from
patient
Lite Individual
Capabilities of the carers, -includes language, education, training, physical attributes,
supplies
other staff
Explain to all the team choose a leader to call (so all work together) Wash hands Raise bed / prepare patient Position client (good Lower bed..Thank
involved (patient, helpers)
alignment)
everybody
