Continuous Passive Motion (CPM) Machine

Continuous Passive Motion (CPM) Machine 

Purpose: 

To provide continuous range of motion for postoperative total knee replacement patients to promote maximum range of motion, decrease pain, and reduce joint swelling. 

Equipment: 

• CPM Machine 

Procedure: 

1. Delivery and Setup: 

• The vendor will deliver the CPM unit to the facility. 

• Explain the procedure to the patient. 

2. Initial Setup and Supervision: 

• Follow the manufacturer’s recommendations for setup and use. 

• Supervision and determination of the degree of motion and duration will be provided by the physical therapist under the direction of the physician. 

• Once the machine is fitted and set to the patient’s needs, settings will only be changed by the physical therapist under the direction of the physician. 

• Application of the machine will be performed by a licensed professional (e.g., PT, PTA, RN, LPN). 

3. Physician Orders: 

• The physician will write specific orders to include degrees of knee flexion and extension, speed of movement, progression of range of motion, and hours of usage per day. 

4. Application: 

• Place the CPM machine at the foot of the bed and plug the cord into a wall outlet. 

• Provide the patient with the hand control and kill switch during use. 

• Administer analgesics as ordered. 

• Position the patient’s leg in the CPM machine so that the foot rests comfortably against the foot plate and the knee aligns with the hinge. The angle should not exceed 30 degrees. 

• Ensure the machine is securely anchored. 

5. Operation: 

• Press the START button to begin motion. 

• Monitor the patient for any signs of discomfort or increased pain and address accordingly. 

6. Removal and Shutdown: 

• To remove the leg from the CPM machine, wait until the leg is extended and press the STOP button. 

• Turn off the power switch before unplugging the CPM machine. 

• If there are any problems with the CPM machine, contact physical therapy or the facility supervisor. 

7. Patient Instructions: 

• Instruct the patient to report any increased pain or discomfort immediately. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Document the use of the CPM machine, including the patient’s response and any observations, in their medical record. 

• Note any adjustments or complications encountered during the procedure. 

• Regularly review and update techniques for using CPM machines according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on proper CPM machine procedures to ensure patient safety and comfort. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.