Clinical Description
- Care of the hospitalized child experiencing limitation in ability to independently and safely move self from one position or place to another.
Key Information
- Development of mobility skills is a complex process involving multiple physiologic systems along with the environment. Mobility impairment is important to address early to avoid limitations in the child’s developmental need to explore and learn.
Clinical Goals
By transition of care
A. The patient will achieve the following goals:
Optimal Mobility
B. Patient, family or significant other will teach back or demonstrate education topics and points:
- Education: Overview
- Education: Self-Management
- Education: When to Seek Medical Attention
Correlate Health Status
Correlate health status to:
- history, comorbidity, congenital anomaly
- age, developmental level
- sex, gender identity
- baseline assessment data
- physiologic status
- response to medication and interventions
- psychosocial status, social determinants of health
- barriers to accessing care and services
- child and family/caregiver:
- health literacy
- cultural and spiritual preferences
- safety risks
- family interaction
- plan for transition of care
Mobility Impairment
Signs/Symptoms/Presentation
- difficulty with transfers
- motor skill limitation
- muscle strength decreased
- range of motion limitation
- reluctance to attempt mobility
- requires assistance with ambulation
- shortness of breath during or after activity
- unable to reposition self independently
Problem Intervention
Optimize Mobility
- Assess mobility skills (e.g., bed, transfers, ambulation, gait, stair climbing, wheelchair) and factors influencing mobility, such as balance, safety, range of motion, strength, muscle tone, cognition and sensory processing.
- Instruct in transfer and mobility techniques supporting highest level of independence while ensuring safety.
- Consider any contraindications or precautions to individualize treatment plan (e.g., joint or ligament instability, weightbearing restrictions).
- Encourage early mobilization and performance of daily activities, if able, while providing level of assistance needed for safety.
- Schedule mobility activities when pain and fatigue are at a minimum to encourage optimal performance.
- Pace activity; allow adequate time and rest periods to conserve energy.
- Provide frequent encouragement, along with prompting and assistance as needed.
- Individualize instructions and prompts to patient’s cognitive status to promote effective communication; simplify verbal directions, give encouragement and provide demonstrated cues as needed.
- Design and implement therapeutic interventions to address impairments (e.g., functional mobility training, mat and standing balance activities, strengthening).
- Train in and reinforce use of adaptive equipment and assistive devices, such as a scooter or walker.
- Encourage self-initiated mobility to facilitate growth and development.
- Utilize appropriate modalities, devices or techniques to facilitate mobility (e.g., ankle foot orthosis, electrical stimulation, partial-weight-treadmill training).
- Assess fall risk using standardized tool; implement appropriate interventions, such as behavioral or environmental modifications.
Associated Documentation
- Activity Management
- Assistive Device Utilized
- Positioning/Transfer Devices
Education
CPG-Specific Education Topics
Overview
risk factors
signs/symptoms
Self-Management
assistive/adaptive devices
energy conservation
home safety
joint mobility/strength
When to Seek Medical Attention
unresolved/worsening symptoms
General Education Topics
General Education
admission, transition of care
orientation to care setting, routine
advance care planning
diagnostic tests/procedures
diet modification
opioid medication management
oral health
medication management
pain assessment process
safe medication disposal
tobacco use, smoke exposure
treatment plan
Safety Education
call light use
equipment/home supplies
fall prevention
harm prevention
infection prevention
MDRO (multidrug-resistant organism) care
personal health information
resources for support
