Set of activities to mobilize a patient who is unable to perform them on his or her own.
Objectives:
– Maintain the comfort of the bedridden patient. – Maintain the patient’s body alignment. – Prevent possible complications (pressure ulcers, deformities, loss of muscle tone, circulatory disorders, etc.).
Equipment:
– Pillows, as needed. – Balkan arc. – Mechanical systems for mobilizing patients. – Bed linen: fitted sheet as a tuck-in, sheets. – Armchair. – Trapeze.
Material:
– Non-sterile gloves. – Nursing records.
Procedure:
– Before mobilizing a patient assess the allowable exercise intensity, the patient’s physical capacity, ability to understand instructions, comfort or discomfort produced by the movement, the patient’s weight, the presence of orthostatic hypotension, and your own strength and ability to mobilize the patient. – Use appropriate body mechanics to avoid self-injury. – Wash hands. – Prepare the material. – Preserve the patient’s privacy. – Inform the patient. – Ask the patient and family to cooperate. – Put on non-sterile gloves. – Place the bed in an adequate and restrained position. – Protect lines, drains, probes and other devices that the patient may have. – Face the direction of movement to avoid turning the back.
– Adopt a broad-based posture to increase stability and maintain balance. -Tilt the trunk forward and flex the hips to lower the center of gravity. -Contract the gluteal, abdominal, leg and arm muscles to rehearse the movement and avoid injury. -Swing from the front leg to the back leg when pulling, or from the back leg to the front leg when pushing to overcome inertia, resist the patient’s weight and more easily obtain a smooth, balanced movement. – Mobilize the patient to the selected position avoiding friction and sudden jerks. – Place support devices necessary to maintain body alignment (pillows, stirrups, foot boots, etc.). – Monitoring of the patient’s general condition. – Leave the patient in a comfortable position. – Remove the material used. – Remove gloves. – Wash hands. – Record the care performed in the nursing records.
Observations:
– Alignment problems that can most often be corrected with supportive devices are: 1. Neck flexion. Internal rotation of the shoulder. 3. Shoulder adduction. 4. Wrist flexion. 5. Anterior convexity of the lumbar spine. 6. External rotation of the hips. 7. Hyperextension of the knees. 8. Plantar flexion of the ankle. – Avoid pain, anxiety and confusion. – Avoid prolonged pressure on the same area. – When the patient is wearing mechanical traction: 1. When mobilizing the patient in bed, one person should monitor the traction elements to control tension, avoid displacements, avoid muscle contractions and maintain the alignment of the traction axis. 2. Monitor local alterations of the affected area: redness, edema, suppuration.
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