parkinsons disease nursing diagnosis impaired physical mobility

PARKINSONS DISEASE NURSING DIAGNOSIS IMPAIRED PHYSICAL MOBILITY SKIN

In 2013 the American Nurses Association (ANA) published Safe Patient Handling and Mobility (SPHM) standards. Combinations of these factors, such as high exertion while in an awkward posture (for example, holding a patient’s leg while bent over and twisted), unpredictable patient movements, and extended reaching, intensify the risk. Although using proper body mechanics and good lifting techniques are important, they don’t prevent lifting injuries in these patient circumstances, , Factors that increase risk for lifting injuries in nurses are exertion, frequency, posture, and duration of exposure. Because patients don’t come in simple shapes and may sit or lie in awkward positions, move unexpectedly, or have wounds or devices that interfere with lifting, the safe lifting load for patients is less than this maximum 50 pound load. For example, a maximum load for employees lifting a box with handles is 50 pounds (23 kg), but this weight is decreased when the lifter has to reach, lift from near the floor, or assume a twisted or awkward position. The National Institute of Occupational Safety and Health (NIOSH) calculates maximum loads for lifting, pushing, pulling, and carrying for all types of employees. Body mechanics involves the coordinated effort of muscles, bones, and one’s nervous system to maintain balance, posture, and alignment when moving, transferring, and positioning patients. Many employers and nurses previously believed that lifting injuries could be prevented by using proper body mechanics, but evidence contradicts this assumption. Nonetheless, nurses still suffer more musculoskeletal disorders from lifting than other employees in the manufacturing and construction industries. A focus on safe patient handling and mobility (SPHM) in acute and long-term care over the past decade has resulted in decreased staff lifting injuries for the first time in 30 years. Read additional information about the Banner Mobility Assessment Tool (BMAT) using the following hyperlink.Īssisting patients with decreased immobility poses an increased risk of injury to health care workers. It then provides guidance regarding the SPHM technology needed to safely lift, transfer, and mobilize the patient. It is used as a nurse-driven bedside assessment of patient mobility and walks the patient through a four-step functional task list and identifies the mobility level the patient can achieve. The Banner Mobility Assessment Tool (BMAT) was developed to provide guidance regarding safe patient handling and mobility (SPHM). However, this test and other tests do not provide guidance on what the nurse should do if the patient can’t maintain seated balance, bear weight, or stand and walk. As the patient performs these maneuvers, their posture, body alignment, balance, and gait are analyzed. The Timed Get Up and Go Test begins by having the patient stand up from an armchair, walk three yards, turn around, walk back to the chair, and sit down. Several objective screening tests, such as the Timed Get Up and Go Test, have traditionally been used by nurses to assess a patient’s mobility status. For example, the patient may have unrecognized physical deconditioning from the disease or injury that necessitated hospitalization, or they may have developed new cognitive impairments related to the admitting diagnosis or their current medications. Staff may frequently rely on the patient’s or a family member’s report on the patient’s ability to stand, transfer, and ambulate, but this information can be unreliable. In addition to reviewing orders regarding weight-bearing and assistance required, all staff should assess patient mobility before and during interventions, such as transferring from surface to surface or during ambulation. See Figure 13.2 for an image of a patient with impaired mobility who developed a DVT.

PARKINSONS DISEASE NURSING DIAGNOSIS IMPAIRED PHYSICAL MOBILITY SKIN

,, Decreased mobility is also a major risk factor for skin breakdown, as indicated on the Braden Scale. See Table 13.2a for a summary of the effects of immobility on these body systems. Mobilization also decreased depression, anxiety, and symptom distress, while enhancing comfort, satisfaction, quality of life, and independence. Findings from a literature review demonstrated several benefits of mobilization, including less delirium, pain, urinary discomfort, urinary tract infection, fatigue, deep vein thrombosis (DVT), and pneumonia, as well as an improved ability to void. Promoting mobility can prevent these complications from occurring.

Regardless of the cause, immobility can cause degradation of cardiovascular, respiratory, gastrointestinal, and musculoskeletal functioning. Patients who spend an extended period of time in bed as they recover from surgery, injury, or illness can develop a variety of complications due to loss of muscle strength (estimated at a rate of 20% per week of immobility).

Parkinsons disease nursing diagnosis impaired physical mobility