Movement

Foundations of Mobility and Movement

  • Definition of Mobility: Mobility is defined as the ability to move freely within the environment.

  • Significance of Mobility:

    • It is fundamental to normal daily functioning.

    • It directly affects a person's ability to perform Activities of Daily Living (ADLs).

    • It impacts the ability to perform job-related and role-related activities.

    • Movement serves as a significant factor in stress-release, protection, and the development of self-concept.

  • Anatomical Basis: The musculoskeletal system serves as the supporting framework for the body and is vital to maintaining mobility.

Foundations of Safety in Nursing

  • Definition of Safety: Safety is the state of being free from harm or danger.

  • Impact of Safety:

    • It prevents harm and injury to individuals.

    • It allows people to feel secure.

    • It reduces stress, promotes general health, and facilitates the ability of individuals to meet other basic needs.

  • Nursing Responsibilities: Nurses are professionally responsible for:

    • Assessing the patient and the surrounding environment.

    • Providing safe care that includes active injury control.

    • Maintaining a safe environment for the patient.

Factors and Assessments for Mobility and Safety

  • Factors Affecting Mobility and Safety:

    • Physiological status, including vitals such as Arterial Blood Pressure (ART) documented at 97/4597/45 with a mean of (63)(63).

    • Oxygenation status, such as Oxygen Saturation (SpO2) at 100100.

  • Nursing Assessments for Mobility and Safety:

    • Subjective Assessment/Review of Systems (ROS): Gathering patient-reported data regarding their movement and history.

    • Physical Assessment: Objective observation and manual examination of the patient's physical capabilities.

    • Diagnostic Tests/Labs: Utilizing clinical data and laboratory results to determine underlying issues affecting mobility.

Physiological and Psychosocial Impacts of Immobility

  • Systemic Effects of Immobility: Immobility has a comprehensive negative impact on multiple body systems, including:

    • Cardiovascular System: Changes in heart rate, cardiac output, and risks of venous stasis.

    • Respiratory System: Potential for decreased lung expansion and secretion pooling.

    • Musculoskeletal System: Muscle atrophy and joint contractures.

    • Integumentary System (Skin): Increased risk of pressure injuries and skin breakdown.

    • Urinary System: Potential for urinary stasis and infection.

    • Gastrointestinal System: Reduced peristalsis and risk of constipation.

    • Neurological System: Possible changes in sensory perception.

    • Psychosocial Health: Impact on mood, mental health, and social interaction.

Nursing Interventions for Mobility and Safety

  • Nursing interventions related to safety are categorized into two broad domains:

    1. Safety Education: Providing instruction for safety within the home, workplace, and general community.

    2. Healthcare Environment Safety: Ensuring and providing a safe environment within the healthcare setting.

Principles of Body Mechanics

  • Definition of Body Mechanics: This involves the coordinated effort of using alignment, posture, and balance to perform physical activities such as:

    • Lifting

    • Bending

    • Moving

  • General Rules: The protocol involves specific general rules of body mechanics to ensure clinician and patient safety (though external rules are referenced rather than listed in detail, alignment, posture, and balance are the core components).

Patient Positioning and Fall Precautions

  • Therapeutic Positioning Techniques: Including, but not limited to:

    • Supine

    • Fowler’s

    • Semi-Fowler’s

    • Prone

    • Side-lying

  • Turning Schedules: Implementation of scheduled changes in position to protect skin integrity and promote circulation.

  • Fall Precautions:

    • Risk Identification: Determining "Who is at risk for falls?" through clinical assessment.

    • Universal Precautions: Standard safety measures applied to all patients to mitigate fall risks.

Ambulation Preparation and Assistance

  • Pre-ambulation Interventions:

    • Muscle Strengthening: Exercises designed to prepare the musculoskeletal system for weight-bearing.

    • Dangling the Legs: Allowing the patient to sit on the edge of the bed with legs hanging to stabilize blood pressure before standing.

  • Ambulation Assistance:

    • Use of transfer belts or gait belts (Note: Specialized training covered in the Mobility II class).

  • Ambulation Aids: (Note: Detailed instruction covered in the Mobility II class)

    • Walkers

    • Canes and Quad canes

    • Crutches

Mechanical Aids and Techniques for Safe Transfer and Lifting

  • Lift Teams: Dedicated personnel specialized in safe patient movement.

  • Hydraulic Lifts: Mechanical devices used for lifting heavy loads/patients.

  • Ceiling Lifts: Track-mounted systems for moving patients throughout a room.

  • Stand-up Assist Lifts: Devices designed to transition patients from a seated to a standing position.

  • Hovermatts: Air-assisted transfer systems to reduce friction and shearing during lateral transfers.

  • Gait Belts: Safety devices used to help move or steady a patient during walking or transfers.

  • Slide Boards: Rigid boards used to bridge gaps between surfaces (e.g., bed to stretcher) for lateral movement.