Policy Manual sample

MDT Home Health Care Agency, Inc. 99 RANGE OF MOTION PURPOSE: Patients are provided or assisted with passive/active range of motion exercises, as appropriate, to prevent contractures of joints or muscle atrophy, to increase or maintain existing function of joint, and to maintain and increase existing muscle tone and strength. RESPONSIBLE PERSONNEL: RN, LPN, OT, PT, and HHA who has received training and demonstrated acceptable techniques as assigned. SPECIAL CONSIDERATIONS: Range of motion can be carried out during activities of daily living as well as through therapeutic exercises. Careful assessment of the patient to determine level of activity, level of need, tolerance for exercise and emotional stance toward compliance will help in providing a plan tailored to the patient in the home setting. Range of motion exercises are designed to increase independence. It is important to stress this concept with the caregiver. The home care team member should serve as a coach to encourage and teach patient and caregiver appropriate techniques. General guidelines include: 1. A joint should never be forced. 2. Support to the joint being exercised should be provided so that it can move gently and smoothly through the appropriate range. 3. Specific exercise programs developed by the therapist will list the number of times an exercise should be performed. In cases where no specific number of exercises per joint has been established, three to five slow smooth completions of the range are usually sufficient. PROCEDURE: 1. Explain the order and procedure for type of range of motion to patient. 2. Refrain from performing passive range of motion if patient has: a. Septic joints b. Acute thrombophlebitis c. Severe arthritic joint inflammation d. Recent trauma with possible fractures or internal injuries 3. Wash your hands. 4. Provide for patient privacy. 5. Position patient comfortably. 6. Position yourself for appropriate body mechanics. 7. Repeat each passive range of motion exercise at least three times or more per physician's order. 8. Implement patient's neck extension and flexion passive range of motion exercise as follows: a. Position patient in supine position on bed. b. Support patient's head, placing one hand on back of the head and your other hand on patient's chin. c. Extend patient's neck by bending the head backward, so patient is looking at ceiling. d. Flex patient's neck by bending the head forward, bringing the chin toward the chest. 9. Implement neck lateral flexion passive range of motion exercise as follows: