Salha Majrashi

Supervised by

OUTLINES
To

outline

the
of

nursing management patients requiring immobilization of

the patients.

OBJECTIVES:
To prevent complications specific to immobility.
To promote self care.

Definition
physical restraint as any manual method, physical or

mechanical device, material, or equipment that immobilizes

or reduces the ability of the patient to move

his or her arms, legs, body or head freely . Examples

include wrist or leg restraints, hand mitts, Geri-chairs, and,

in certain situations, full side rails and reclining chairs. B. Etiology: Hospital nurses reasons for use of physical

restraint are prevention of patient disruption of medical

devices and therapy (75%), confusion (25%), and fall prevention (18%).

Introduction
The patient will be assessed for risk factors for alteration in skin

integrity on admission and WOCN notified/consulted if indicated. This skin assessment shall be documented in the 24 Hour Nurses Note.
integrity and circulatory impairment each shift (8-12 hours).

The patient at risk will be reassessed for alteration in skin The patient will be positioned utilizing proper body alignment

and turned/repositioned at least every 2-3 hours unless contraindicated. (If contraindications present, document contraindications in the 24 Hour Nurses Note). beds and/or skin care will be utilized, as appropriate and as ordered. Pressure devices such as foam or pillows may be placed between bony prominences to prevent direct contact.

Pressure reduction measures such as heel/elbow pads, specialty

 The head of the bed will be maintained at the lowest degree of

elevation consistent with medical conditions and other restrictions (30 degrees or less when possible). Exception: An upright position may be used during meals and one hour after eating. nutritional services policy.

A nutritional consult will be initiated as indicated per

Plastic backed incontinence pads/diapers will not be placed next

to patient's skin. The patient will be assessed for moisture or soiling with each repositioning and as indicated. using available incontinent care products. and/or as ordered by MD.

Skin protection for the incontinent patient will be managed Deep breathing and coughing will be encouraged as needed

 Range of motion exercises will be performed daily as

possible.

Diversionary activities such as family visitation, TV,

reading, etc. will be encouraged. will be encouraged.

Independence within the limitations of immobility The patient will be monitored for BMs daily, and MD

shall be notified if no BM noted in 3 days.

The patient/significant other will be instructed

regarding disease process and prevention of skin breakdown.

Purpose
Traction is usually applied to the

arms

and

legs,

the

neck,

the

backbone, or the pelvis. It is used to

treat fractures, dislocations, and

long-duration muscle spasms, and to prevent or correct deformities.

Traction can either be short-term, as

at an accident scene, or long-term, when it is used in a hospital setting.

 Traction serves several purposes: it aligns the ends of a fracture by pulling

the limb into a straight position

it ends muscle spasm it relieves pain it takes the pressure off the bone ends by

relaxing the muscle

 There are two main types of traction: skin traction

and skeletal traction. Within these types, many specialized forms of traction have been developed to address problems in particular parts of the body. The application of traction is an exacting technique that requires training and experience,

since incorrectly applied traction can cause harm.

Precautions
People who are suffering from skin disorders or who

are allergic to tape should not undergo skin traction, because the application of traction will aggravate their condition. Likewise, circulatory disorders or varicose veins can be aggravated by skin traction. People with

an inflammation of the bone (osteomyelitis) should

not undergo skeletal traction.