Nursing Practice Mobility and

Immobility
Reference
Crisp, J. and Taylor, C. (2009) Potter &
Perrys fundamental s of nursing. 3
rd

edition. Chatswood: Elsevier.
Key Terms
abdution
addution
body ali!n"ent
base o# support
body "ehanis
dorsal (supine)
dorsal reu"bent
dorsi#le$ion
e$tension
#le$ion
hypere$tension
i""obility
%oint
"obility
orthopnoei
pronation
prone
ran!e&o#&"otion ('())
se"i&*owler+s position
,i"+s position
supination
Principles of body mechanics
-ody "ehanis
.li!n"ent
-alane
/ravity and #rition
Body mechanics
Co&ordinated e##orts o#
"usular 0 s1eletal syste" to "aintain,
balane posture and body ali!n"ent
durin! li#tin!, bendin!, "ovin! and
per#or"in! ativities o# daily livin!.
/ood body "ehanis redues
the ris1 o# in%ury #or nurses and patients
Alignment
&good alignment
(or strai!ht 0 proper anato"ial
positionin!) is i"portant when
standin! sittin! or lyin!
&helps to redue in%ury #or nurses and
patients.
Balance
-alane ontrol "eans the
entre o# !ravity is appropriate #or the
tas1 at hand
Balance is best with
&a wide base o# support
&low entre o# !ravity 1ept in the base
o# support
Gravity and friction
The eight o# an ob%et person
is the #ore e$erted #ro" !ravity
!riction ours when two
sur#aes rub a!ainst another
Movement of the human body
2hat do we 1now3 s1eletal syste",
"usles44.
Mobility and immobility
)obility is the ability to "ove
#reely
&advanta!es o# "obility inlude:44
5E$erise and "ove"ent has been
shown to have positive outo"es #or all
"a%or syste"s o# the body6 (p7289)
:""obility is4..

:"paired physial "obility "ay i"pat
on all syste"s o# the body
"omplications of Immobility
)etaboli han!es
'espiratory han!es
Cardiovasular han!es
)usulos1eletal han!es
;rinary eli"ination han!es
:nte!u"entary han!es
"omplications of immobility include#
"usle and bone atrophy
ontratures
pressure ulers
onstipation
;T: (urinary trat in#etion)
postural hypotension
anore$ia
inso"nia
.sthenia
disorientation
Nurses $noledge
<nowled!e about the i"pat o#
i""obility on patients and the use o#
interventions ai"ed to ounterat the
e##ets o# i""obility an prevent #urther
pain% suffering and complications
Assessment of immobility Include
'an!e o# "otion ('()) o# %oints =
/ait (style o# wal1in!)
E$erise and ativity tolerane
-ody ali!n"ent
'() o# a %oint =
Joints
&#le$ion
&e$tension
&rotation
&abdution 0 addution
&pivotal
Nursing Interventions to reduce the
impact of immobility
:ndividualised #or eah patient
Range&of&motion 'R(M)
e$erises
&(active patient independently or
passive nurse "oves eah %oint)
&"ini"u" 2&3 ti"es eah day
Reposition re!ularly ensurin!
!ood body ali!n"ent,
Ambulation : re!ular and sa#e
/ood nutrition =
.de>uate #luid inta1e
)onitor eli"ination
.ssess s1in inte!rity
)onitor sleep
Ensure sti"ulation
;se o# aids e.!. !ait belt
Promote independence
*or$ing ith patients
:t is essential that nurses use
!ood body "ehanis when wor1in!
with patients.
/ood body "ehanis redues
the ris1 o# in%ury #or nurses
Bac$ground Information
?urses have one o# the hi!hest
inidenes o# any oupational !roup #or
wor1&related, "usulos1eletal in%uries
:n 7999, .CC lai"s by nurses
ost "ore than +,- Million dollars
Bac$ground Information
?ew @ealand Aatient Bandlin!
/uidelines (2003)
.IT/N 0P and R/10"/ T2/ RI3K
.IT/
C oad
: ndividual
T as1
E nviron"ent
.ite .oad
Charateristis that an a##et
the handlin! ris1:
:nludes:
a!e, !ender, dia!nosis, neurolo!ial
status, siDe, wei!ht, ability to o&
operate and ris1 o# #alls, sur!ial
li"itations, sin ondition
&ability to hear and see
Cite Individual
Capabilities o# the arers,
&inludes lan!ua!e, eduation, trainin!,
physial attributes,
&physial li"itations, stress and #ati!ue
Cite Tas$
2hat has to be done, how and
when
& steps involved, a no"inated leader,
do : need e>uip"ent, an the patient
help
.ite /nvironment
The wor1in! environ"ent
&#ailities, sta##in! levels, ulture and
resoures
)a$i"u" Ci"its
7E 1! li"it
?ote: ?ot sa#ety li"its
)ales: 2F 1ilos
*e"ales: 7E.E 1ilos
-ut44..only when4..
Bandlin! done in a suitable
environ"ent
Carers "aintain !ood posture
Coad is held lose to the "id&
body ran!e between elbow and 1nu1le
hei!ht
Ci"its drop si!ni#iantly in other
positionsG
Putting it all together
2henever you wor1 with a
patient
:ntrodue yoursel#
Assess all aspets o# .IT/
Collet e>uip"ent and supplies
'e>uest assistane #ro" other
sta##
E$plain to all the 5tea"6 involved
(patient, helpers)
hoose a leader to all (so all wor1
to!ether)
2ash hands
'aise bed 0 prepare patient
Aosition lient (!ood ali!n"ent)
Cower bed44..Than1
everybody