IMPAIRED BED MOBILITY
Limitation of independent movement from one bed position to another
Impaired ability to perform the following actions while in bed:
• Move from supine to long sitting or long sitting to supine
• Move from supine to prone or prone to supine
• Move from supine to sitting or sitting to supine
• “Scoot” or reposition body
• Turn from side to side
• Cognitive impairment
• Musculoskeletal and/or
• Deﬁcient knowledge
• Environmental constraints
• Insufﬁcient muscle strength
• Sedating medications
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Pharmacological function
• Physical regulation
The patient will
• Have no complications associated with impaired bed mobility,
such as altered skin integrity, contractures, venous stasis, thrombus
formation, depression, altered health maintenance, and falls.
• Maintain or improve muscle strength and joint ROM.
• Achieve the highest level of bed mobility possible (independence,
independence with device, verbalization of needs for assistance with
bed mobility, requires assistance of one person or two people).
• Demonstrate ability to use equipment or devices to assist with
moving about in bed safely.
• Adapt to alteration in ability to move about in bed.
• Participate in social, physical, and occupational activities to the
SUGGESTED NOC OUTCOMES
Body Positioning: Self-Initiated; Cognition; Immobility
Consequences: Physiological; Immobility Consequences: Psychocogni-
tive; Joint Movement, Mobility; Neurological Status: Consciousness
INTERVENTIONS AND RATIONALES
Determine: Identify patient’s level of independence using functional
mobility scale and document ﬁndings to provide continuity of care.
Monitor and record daily evidence of complications related to
impaired bed mobility (contractures, venous stasis, skin breakdown,
thrombus formation, depression, altered health maintenance or self-
care skills, falls). Assess patient’s skin every 2 hr to maintain skin
Perform: Perform ROM exercises to affected joints, unless
contraindicated, at least once per shift. Progress from passive to
active ROM, as tolerated, to prevent joint contractures and muscle
Assist patient in maintaining anatomically correct and functional
body positioning to relieve pressure, thereby preventing skin break-
down and ﬂuid accumulation in dependent extremities. Encourage
repositioning every 2 hr while in bed.
Establish a turning schedule for immobile patient. Encourage pro-
gressive mobility within patient’s limits to maintain muscle tone,
prevent complications, and promote self-care.
If you are uncertain about your ability to move the patient,
request help from colleagues to maintain safety.
Inform: Instruct patient and family members in techniques to
improve bed mobility and ways to prevent complications to help
prepare the patient and family members for discharge.
Demonstrate patient’s bed mobility regimen and note the date.
Have patient and family members perform a return demonstration
to ensure continuity of care and use of proper technique.
Attend: Encourage patient to participate in physical and
occupational therapy sessions. Incorporate equipment, devices, and
techniques used by therapists into your care. Request written
instructions from the patient’s therapists to use as a reference to
help ensure continuity of care and reinforce learned skills.
Manage: Refer patient to a physical therapist to continue improve-
ment in bed mobility and rehabilitate musculoskeletal deﬁcits; and
an occupational therapist to continue to maximize self-care skills.
Assist patient in identifying and contacting resources for social
and spiritual support to promote the patient’s reintegration into the
community and help him maintain psychosocial health.
SUGGESTED NIC INTERVENTIONS
Bed Rest Care; Body Mechanics Promotion; Exercise Promotion:
Strength Training; Exercise Therapy: Joint Mobility; Exercise Ther-
apy: Muscle Control; Positioning
Lyder, C. H. (2006, August). Assessing risk and preventing pressure ulcers in
patients with cancer. Seminars in Oncology Nursing, 22(3), 178–184.