Nursing Skills in Supporting Mobility

Sheila Cunningham, Tina Moore

• Publisher: Routledge
• Year: 2021
• eBook ISBN: 9781351065566
• Edition: 1
• Topic: Medicine
• Subtopic: Health Care Delivery

The ability to move easily and purposively contributes enormously to a sense of health and wellbeing, enabling increased independence and selfprotection. However, many of the patients you encounter will have some degree of immobility whether it is temporary (for instance, due to local anaesthesia), permanent (for instance, due to amputation or stroke) or variable (for instance, due to arthritis or morbid obesity). This practical pocket guide covers:

• the anatomy and physiology of the musculoskeletal system

• the principles of ergonomics

• safe moving and handling practices

• positioning the patient

• performing a range of movement exercises

• legal aspects of moving and handling

• the promotion of sleep.

This competency-based text covers relevant key concepts, anatomy and physiology, lifespan matters, assessment and nursing skills. To support your learning, it also includes learning outcomes, concept map summaries, activities, questions and scenarios with sample answers and critical reflection thinking points.

Quick and easy to reference, this short, clinically-focused guide is ideal for use on placements or for revision. It is suitable for pre-registration nurses, students on the nursing associate programme and newly qualified nurses.

CHAPTER 1
Overview of musculoskeletal components and movement

Sheila Cunningham

Overview

The musculoskeletal system provides form, stability and movement to the human body. It consists of the body’s bones (which make up the skeleton), muscles, tendons, ligaments, joints, cartilage and other connective tissue.

Link to Future Nurse Proficiencies (NMC 2018)

• Platform 4 Providing and evaluating care (specifically, 4.7).
• Annexe B: Nursing procedures, Section 7: Use evidence-based, best practice approaches for meeting needs for care and support with mobility and safety, accurately assessing the person’s capacity for independence and self-care and initiating appropriate interventions.

Expected knowledge

• Connective tissue and general role of the musculoskeletal system
• Correct posture and consequences of poor posture.

Introduction

One of the four tissues types in the body is ‘connective tissue’. This term describes the tissue that supports and binds tissues and organs together, namely ligaments and tendons. The chief components are collagen and elastic fibres, which are composed of a variety of different proteins. This enables them not only to be strong and durable but also flexible and elastic. In normal everyday activities, the range, speed and duration of movements cause stress on muscles, bones and connective tissues. These physical stresses and forces contribute to strength, resilience and endurance of the MSK but can also subject the system to overstressing, causing trauma or degeneration. This may be seen in certain areas such as sport, in damage to ligaments or when a person falls and sprains an ankle. To really understand this a nurse ought to be aware of the structures, forces and processes which contribute to these movements, in addition to understanding the consequences if movements are incomplete, excessive or in some cases impossible due to other traumas or developmental problems. Whilst anatomy can be a challenging topic to grasp, it is a core element to understanding activities of daily living (walking/moving); it is the evidence that underpins assessment, decisions and care practices.

Content

Bones structure and function	Ossification	Types of body movements
Skeletal muscle structure and function	Posture and movement	Joints

Learning outcomes

• Outline the components of the musculoskeletal system
• Describe the process of bone growth, ossification and changes with age
• Differentiate the different joints and types of body movements and processes involved including lever systems
• Explain the terms and significance of biomechanics and ergogenics to movement.

Key background

Bone growth is dynamic and undergoes a continuous process termed ‘modelling’ and ‘remodelling’. Through this older bone tissue is gradually replaced by new bone tissue in a continuous way. It is estimated that every bone in the body is completely reformed about every ten years (MSD, 2020); though this is conjecture, it reflects the dynamic process. All bones have essentially the same structure: a hard outer part (cortical bone) and a softer inner part (trabecular bone). This latter part is less dense than the hard outer part but still contributes significantly to bone strength. A reduction in the amount or quality of trabecular bone increases the risk of fractures (breaks). In order to maintain bone density and strength an adequate supply of calcium, vitamin D and other materials are necessary. Hormones also contribute to bone health: growth hormones, calcitonin, parathyroid hormones, oestrogen and testosterone. Weight-bearing activities (e.g. walking, jogging, skipping) where the limbs propel the body into a movement help bones strengthen by encouraging bone generation and remodelling. From this the soft...

Table of contents

• Cover
• Half-Title
• Series
• Title
• Copyright
• Contents
• LIST OF FIGURES
• INTRODUCTION TO THE SKILLS IN NURSING PRACTICE SERIES
• INTRODUCTION AND OVERVIEW
• Chapter 1 Overview of musculoskeletal components and movement
• Chapter 2 Movement assessment and exercises
• Chapter 3 Safe moving and handling practices
• Chapter 4 Therapeutic and procedural positions
• Chapter 5 Legal aspects of moving and handling
• BIBLIOGRAPHY
• INDEX