Positioning Flashcards
What is the position of comfort?
Position of contracture
Therapeutic positioning
Positioning for maximizing tissue and joint function
Positioning is done for
Patient comfort
Therapeutic benefit
Pressure relief
Joint integrity
Contracture Concerns
Limit function
Hygiene
Introduce skin or tissue compromise
Pressure Relief Goal
Disperse pressure
Risk Factors for Pressure Problems
Level of independence Orientation/level of consciousness Continence Sensory function Nutrition
Pressure Problem Risk Areas
Bony prominences
Sacrum
Occipital tuberosity
Post calcaneus
Braden Risk Assessment
Used by nurses for skin assessment
6 Areas of Braden Assessment
Sensory perception Moisture Activity Mobility Nutrition Friction/shear
Foundation of Positioning
2 hour - alternating position
Alleviate pressure
Correct flexible vs accommodating fix deformity
High Risk Contracture Areas
Knee and hip flexion
PF
Neck rotation
Shoulder extensors/adductor/IR’s
Amputation Positioning
Offset prolonged sitting with prone (20-30 min, 3x/day)
No knee flexion in bed
AKA Amputation Focus
Hip extension and adduction
BKA Amputation Focus
Hip and knee extension
Neuro Positioning
To normalize tone
Prevent/accommodate contracture
Stretch shortened structures
Wound/Burn Positioning
Require special attention
Wound tissue shorten -> position for scar elongation
Greatest risk where scars are across/extend past joint
Restraint
Device that is intended for medical purposes and limits the patient’s movements to the extent necessary for treatment
Restraint Characteristics
Includes anything that the patient can’t move on their own
For patients with mobility deficits and fall risk
Chemical/Pharmacologic Restraints
Medications to control behavior
Physical Restraints
Anything that limits movement, restricts freedom of movement or normal access to one’s body
Restraint Rules
Requires physician’s order, renewed every 24 hours
Face-to-Face evaluation every hour
Exhausted restraint alternatives
Does not include devices for the purpose of conducting routine physical examinations, tests, or procedures or to protect the patient from falling out of bed, or to permit the patient to participate in activities w/out the risk of physical harm
Use the least restrictive and safest restraint, follow protocol
Validate continued use of restraints
Don’t use sheets or gait belts as restraints
