 Mobility is the ability to move freely, easily, and purposefully in the environment.  Individuals must move to protect themselves from trauma and to meet their basic needs. Mobility is vital to independence

 Prolonged inactivity can lead to physical and mental deterioration  You will care for patients who are inactive from: ◦ Immobility ◦ Prescribed bed rest ◦ Critical illness ◦ Neurological damage ◦ Trauma ◦ Pain

 Impaired physical mobility related to:  Risk for injury related to:  Activity intolerance related to:

 The patient will:

 Use of the body (nervous and musculoskeletal system) in movement (lifting, bending, moving) and at rest

 Health care workers use proper body mechanics to: 1.Reduce fatigue 2.Prevent Injury 3.Maintain balance 4.Conserve Energy

1. Center of Gravity – located in the pelvis, it is the point where the body’s mass is centered. 2. Line of Gravity - Balance is maintained when the line of gravity passes through the base of support or center of gravity. ( base of support includes the feet and the distance between the feet)

1. Size up your load to determine whether you need help. Know your abilities and limitations when lifting. Get help or find an alternative method of moving the patient. 2. It is easier to push, pull, or roll an object rather than to lift it. Pulling is easier than pushing, - so pull patients toward you rather than pushing them.

3. The wider the base of support and the lower the center of gravity, the greater the stability. You can lower your center of gravity by bending your knees You can widen the base of support by moving your feet apart

4. Objects that are closer to the center of gravity, the more effective and stable that force is, and are moved with less effort - To support a patient, stand close, keep them close to your body - Carry an object close to your body 5. The amount of work required to move an object is directly related to the amount of resistance and gravitational pull. Friction is a resistive force between two objects. - keep sheets wrinkle free to decrease friction - lower the head of bed to move patient up in bed

6. Use the larger and stronger muscles of legs and arms rather than the weaker muscles of your back. It is less fatiguing and safer. 7. Move your body as a unit – avoid twisting, stretching, or stooping -keep your back straight -Twisting the back causes a shift in balance and can strain the structures in the low back area -Face in the direction you are moving

1. Twisting (rotation) of the thoracolumbar, stretching, or reaching. 2. Acute flexion of the back with hips and knees straight (stooping).

Move your body as a Unit

 Plan ahead ** If the patient is unable to assist with the transfer or If the patient is large GET HELP !

1. Note conditions that impair the patient’s activity and mobility 2. Observe position in bed, alignment 3. Identify the patient’s level of consciousness and capacity for following directions 4. Determine the patient’s strength and ability to assist with moving 5. Estimate the effort required to move the patient in relation to his size, wt.

1. Change the position every 2 hours unless otherwise indicated 2. You do not need an order to turn a patient, but the doctor should write an activity order 3. Aim= put the least amount of stress on his / her joints and skin.

4. Use a draw sheet to reduce shearing force on the patient’s skin 5. If you place the patient in proper alignment, he will remain functional and unstressed 6. If patient is too large, get help 7. Falls are the most common hazard, so be aware of measure to prevent this

8. Put on foot covers—patients shoes, slippers with firm soles. 9. Get the patient to assist if possible 10. When moving a patient up in bed, have them bend their knees and place soles firmly on bed– this reduces drag.

11. Be sure everyone knows what is expected on them, including the patient. Communicate your intention clearly 12. If restraint devices are being used- remove and reapply. 13. Be sure locks are “on” all moveable equipment. 14. Document patient’s activity and how tolerated activity as soon as finished.

 Frequent change of position helps to prevent: ◦ Muscle discomfort ◦ Undue pressure resulting in pressure ulcers ◦ Damage to superficial nerves and blood vessels ◦ Contractures

1. Make sure the mattress is firm and level 2. Ensure bed is clean, dry, wrinkle-free 3. Place support devices in specified areas according to the patients condition 4. Avoid placing one part on top of another 5. Ask the patient what position is most comfortable and appropriate.

 Supine  Prone  Fowlers  Lateral / Side-lying  Sims

 Some patient’s who are weak, unsteady, and shaky when first getting out of bed may need help with ambulation.

1. Determine the patient’s most recent activity level 2. Assess patient’s current condition, including fatigue, pain, dizziness, medications 3. Assess environment for safety 4. Assess need for ambulation equipment 5. Assess patient’s shoes and be sure they are safe for walking, and covering.