Care Plan for Contractures - Splint Use

Category / Primary Body System

• Musculoskeletal System

Problem

• Patient is at risk of complications due to contractures and splint use.

Goal

• Patient will tolerate splint use without skin breakdown for 90 days.

Plan/Approach

1. Range of Motion (ROM) Exercises

   • Perform ROM exercises during care as ordered to maintain joint flexibility and prevent stiffness.

2. Pain and Discomfort Monitoring

   • Monitor for any signs or symptoms of pain related to splint use and address promptly.

3. Positioning

   • Reposition the patient as needed to prevent pressure sores and improve comfort.

4. Physical and Occupational Therapy

   • Arrange PT/OT evaluations as needed to assess and support the patient's mobility and use of splints.

5. Splint Application and Maintenance

   • Apply the splint as ordered, ensuring proper fit and comfort.
   • Regularly assess the skin for potential new breakdown related to splint use and adjust care as necessary.

6. Patient and Family Education

   • Educate the patient and family on the importance of ROM exercises and proper splint use.
   • Provide instructions on how to monitor for signs of skin breakdown and pain.

Rationale

1. Range of Motion (ROM) Exercises

   • Regular ROM exercises help maintain joint mobility, reduce stiffness, and prevent contractures from worsening.

2. Pain and Discomfort Monitoring

   • Monitoring and addressing pain ensures that the patient is comfortable and compliant with splint use, which is crucial for effective management.

3. Positioning

   • Frequent repositioning reduces the risk of pressure sores and improves overall comfort, which is essential for patients using splints.

4. Physical and Occupational Therapy

   • PT/OT evaluations provide professional guidance on exercises and techniques to maximize the benefits of splint use and prevent complications.

5. Splint Application and Maintenance

   • Proper application and regular assessment of the splint ensure that it is effective and does not cause additional problems such as skin breakdown.

6. Patient and Family Education

   • Educating the patient and family empowers them to take an active role in care, improving adherence and outcomes.

Actions

1. Range of Motion (ROM) Exercises

   • Perform ROM exercises with the patient during care routines, ensuring all affected joints are exercised as per the care plan.

2. Pain and Discomfort Monitoring

   • Assess the patient for signs of pain or discomfort related to splint use, documenting findings and notifying the healthcare provider if adjustments are needed.

3. Positioning

   • Reposition the patient regularly, at least every two hours or as needed, to prevent pressure sores and promote comfort.

4. Physical and Occupational Therapy

   • Schedule PT/OT evaluations and follow through with recommended exercises and adjustments to splint use.

5. Splint Application and Maintenance

   • Apply the splint as ordered, checking for proper fit and ensuring the patient is comfortable.
   • Inspect the skin under and around the splint daily, looking for signs of redness, pressure sores, or breakdown, and take appropriate action if any issues are found.

6. Patient and Family Education

   • Teach the patient and family about the importance of ROM exercises and demonstrate how to perform them correctly.
   • Provide information on how to recognize and report signs of skin breakdown and pain, encouraging them to notify staff immediately if they observe any issues.