Policy Manual sample

MDT Home Health Care Agency, Inc. 102 28. Implement ankle circumduction passive range of motion exercise as follows: a. Place one hand under patient's ankle and grasp the foot with your other hand. b. Rotate patient's ankle in circular motion. 29. Implement foot inversion and eversion passive range of motion exercise as follows: a. Place one hand under patient's ankle and grasp the foot sole with your other hand, holding the ankle securely. b. Invert or twist patient's foot with the sole toward body midline. c. Evert or twist sole of patient's foot away from body midline. 30. Implement toe extension and flexion passive range of motion exercise as follows: a. Hold patient's ankle securely with one hand, flex or curl patient's toes toward foot sole with your other hand. b. Extend or straighten and stretch patient's toes back toward dorsal surface of the foot. 31. Implement toe abduction and adduction passive range of motion exercise as follows: a. Abduct or spread two of patient's adjoining toes apart. b. Adduct or bring two adjoining toes together. c. Repeat items a and b for all toes. 32. Assist patient with comfort measures. DOCUMENTATION: Document passive range of motion exercise results, date and time of exercise, and pertinent observations made during exercise, such as patient's tolerance of the procedure, patient's needs, outcome, etc., in the patient's clinical record. If further action is indicated, document follow- up/notification of Clinical Manager and/or physician.