4.2 Chain of Infection
Myra Sandquist Reuter, MA, BSN, RN - Open Resources for Nursing (Open RN)
The chain of infection, also referred to as the chain of transmission, describes how an infection spreads based on these six links of transmission:
- Infectious Agent
- Reservoirs
- Portal of Exit
- Modes of Transmission
- Portal of Entry
- Susceptible Host
See Figure 4.1[1] for an illustration of the chain of infection. If any “link” in the chain of infection is removed or neutralized, transmission of infection will not occur. Health care workers must understand how an infectious agent spreads via the chain of transmission so they can break the chain and prevent the transmission of infectious disease. Routine hygienic practices, standard precautions, and transmission-based precautions are used to break the chain of transmission.
The links in the chain of infection include Infectious Agent, Reservoir, Portal of Exit, Mode of Transmission, Portal of Entry, and Susceptible Host[2]:
- Infectious Agent: Microorganisms, such as bacteria, viruses, fungi, or parasites, that can cause infectious disease.
- Reservoir: The host in which infectious agents live, grow, and multiply. Humans, animals, and the environment can be reservoirs. Examples of reservoirs are a person with a common cold, a dog with rabies, or standing water with bacteria. Sometimes a person may carry an infectious agent but is not symptomatic or ill. This is referred to as being colonized, and the person is referred to as a carrier. For example, many health care workers carry methicillin-resistant Staphylococcus aureus (MRSA) bacteria in their noses but are not symptomatic.
- Portal of Exit: The route by which an infectious agent escapes or leaves the reservoir. In humans, the portal of exit is typically a mucous membrane or other opening in the skin. For example, pathogens that cause respiratory diseases usually escape through a person’s nose or mouth.
- Mode of Transmission: The way in which an infectious agent travels to other people and places because they cannot travel on their own. Modes of transmission include contact, droplet, or airborne transmission. For example, touching sheets with drainage from one person’s infected wound and then touching another person without washing one’s hands is an example of contact transmission of an infectious agent. Examples of droplet or airborne transmission are coughing and sneezing, depending on the size of the microorganism.
- Portal of Entry: The route by which an infectious agent enters a new host (i.e., the reverse of the portal of exit). For example, mucous membranes, skin breakdown, and artificial openings in the skin created for the insertion of medical equipment (such as intravenous lines) are at high risk for infection because they provide an open path for microorganisms to enter the body. Tubes inserted into mucous membranes, such as a urinary catheter, also facilitate the entrance of microorganisms into the body. A person’s immune system fights against infectious organisms that have entered the body through the use of nonspecific and specific defenses. Read more about defenses against microorganisms in the “Defenses Against Transmission of Infection” section of this chapter.
- Susceptible Host: A person at elevated risk for developing an infection when exposed to an infectious agent due to changes in their immune system defenses. For example, infants (up to 2 years old) and older adults (aged 65 or older) are at higher risk for developing infections due to underdeveloped or weakened immune systems. Additionally, anyone with chronic medical conditions (such as diabetes) are also at higher risk of developing an infection. In health care settings, almost every patient is considered a “susceptible host” because of preexisting illnesses, medical treatments, medical devices, or medications that increase their vulnerability to developing an infection when exposed to infectious agents in the health care environment. As caregivers, it is the NA’s responsibility to protect susceptible patients by breaking the chain of infection.
After a susceptible host becomes infected, they become a reservoir that can then transmit the infectious agent to another person. If an individual’s immune system successfully fights off the infectious agent, they may not develop an infection, but instead the person may become an asymptomatic “carrier” who can spread the infectious agent to another susceptible host. For example, individuals exposed to COVID-19 may not develop an active respiratory infection but can spread the virus to other susceptible hosts via sneezing.
Learn more about the chain of infection by clicking on the following activities.
This H5P activity is a derivative of original activities by Michelle Hugues and licensed under CC BY-NC 4.0 unless otherwise noted.
This H5P activity is a derivative of original activities by Michelle Hugues and licensed under CC BY-NC 4.0 unless otherwise noted.
This H5P activity is a derivative of original activities by Michelle Hugues and licensed under CC BY-NC 4.0 unless otherwise noted.
This H5P activity is a derivative of original activities by Michelle Hugues and licensed under CC BY-NC 4.0 unless otherwise noted.
This H5P activity is a derivative of original activities by Michelle Hugues and licensed under CC BY-NC 4.0 unless otherwise noted.
This H5P activity is a derivative of original activities by Michelle Hugues and licensed under CC BY-NC 4.0 unless otherwise noted.
Putting It All Together
Note: To enlarge the print, you can expand the activity by clicking the arrows in the right upper corner of the text box. Please drag and drop the descriptors and actions into the appropriate boxes to demonstrate the various steps in the chain of infection.
This H5P activity is a derivative of original activities by Michelle Hugues and licensed under CC BY-NC 4.0 unless otherwise noted.
Healthcare-Acquired Infections
An infection that develops in an individual after being admitted to a health care facility or undergoing a medical procedure is a healthcare-associated infection (HAI), formerly referred to as a nosocomial infection. About 1 in 31 hospital patients develops at least one healthcare-associated infection every day. HAIs increase the cost of care and delay recovery. They are associated with permanent disability, loss of wages, and even death. An example of an HAI is a skin infection that develops in a patient’s incision after they had surgery due to improper hand hygiene of health care workers.[3],[4] It is important to understand the dangers of Healthcare-Acquired Infections and actions that can be taken to prevent them.
Read more details about healthcare-acquired infections in the “Infection” chapter of Open RN Nursing Fundamentals.
Healthcare-Associated Infections by Michelle Hughes is licensed under CC BY 4.0.
- “Chain-of-Transmission” by unknown author is licensed under CC BY-NC 4.0. Access for free at https://ecampusontario.pressbooks.pub/introductiontoipcp/chapter/40/ ↵
- Department of Health. (n.d.). Chain of infection in infection prevention and control (IPAC). The Government of Nunavut. https://www.gov.nu.ca/health/information/infection-prevention-and-control ↵
- This work is a derivative of Nursing Fundamentals by Chippewa Valley Technical College and is licensed under CC BY 4.0 ↵
- Office of Infectious Disease and HIV/AIDS Policy. (n.d.). Health care-associated infections. U.S. Department of Health & Human Services. https://www.hhs.gov/oidp/topics/health-care-associated-infections/index.html ↵
Since the days of Florence Nightingale, sleep has been recognized as beneficial to health and of great importance during nursing care due to its restorative function. It is common for sleep disturbances and changes in sleep pattern to occur in connection with hospitalization, especially among surgical clients. Clients in medical and surgical units often report disrupted sleep, not feeling refreshed by sleep, wakeful periods during the night, and increased sleepiness during the day. Illness and the stress of being hospitalized are causative factors, but other reasons for insufficient sleep in hospitals may be due to an uncomfortable bed, being too warm or too cold, environmental noise such as IV pump alarms, disturbance from health care personnel and other clients, and pain. The presence of intravenous catheters, a urinary catheter, and drainage tubes can also impair sleep. Increased daytime sleepiness, a consequence of poor-quality sleep at night, can cause decreased mobility and slower recovery from surgery. Research indicates that postoperative sleep disturbances can last for months. Therefore, it is important to provide effective nursing interventions to promote sleep.[1]
Assessment
Begin a focused assessment on a client’s sleep patterns by asking an open-ended question such as, “Do you feel rested upon awakening?” From there, five key sleep characteristics should be assessed: sleep duration, sleep quality, sleep timing, daytime alertness, and the presence of a sleep disorder. Examples of focused interview questions are included in Table 12.3a. These questions have been selected from sleep health questionnaires from the National Sleep Foundation's Sleep Health Index and the National Healthy Sleep Awareness Project.[2]
Table 12.3a Focused Interview Questions Regarding Sleep[3]
| Questions | Normal Findings |
|---|---|
| How many hours do you sleep on an average night? | 7-8 hours for adults (See Table 12.3b for recommended sleep by age range.) |
| During the past month, how would you rate your sleep quality overall? | Very good or fairly good |
| Do you go to bed and wake up at the same time every day, even on weekends? | Yes, they generally maintain a consistent sleep schedule |
| How likely is it for you to fall asleep during the daytime without intending to? Do you struggle to stay awake while you are doing things? | Unlikely |
| How often do you have trouble going to sleep or staying asleep? | Never, rarely, or sometimes |
| During the past two weeks, how many times did you have loud snoring while sleeping?
Note: It is helpful to ask the client’s sleep partner this question. |
Never |
It is also helpful to determine the effects of caffeine intake and medications on a client’s sleep pattern. If a client provides information causing a concern for impaired sleep patterns or a sleep disorder, it is helpful to encourage them to create a sleep diary to share with a health care provider. Use the following information to view a sample sleep diary.
Download a Sleep Diary from the National Heart, Lung, and Blood Institute.
Additional subjective assessment questions can be used to gather information about a clients typical sleep routine so that it can be mirrored during inpatient care, when feasible.
Nurses also perform objective assessments of a client’s sleep patterns during inpatient care. The number of hours slept, wakefulness during the night, and episodes of loud snoring or apnea should be documented. Note physical (e.g., sleep apnea, pain, and urinary frequency) or psychological (e.g., fear or anxiety) circumstances that interrupt sleep, as well as sleepiness and napping during the day.[4],[5]
Concerns about signs of sleep disorders should be communicated to the health care provider for follow-up.
Life Span Considerations
The amount of sleep needed changes over the course of a person’s lifetime. Although sleep needs vary from person to person, Table 12.3b shows general recommendations for different age groups based on recommendations from the American Academy of Sleep Medicine (AASM) and the American Academy of Pediatrics (AAP).[6]
Table 12.3b Recommended Amounts of Sleep by Age Group[7]
| Age | Recommended Amount of Sleep |
|---|---|
| Infants aged 4-12 months | 12-16 hours a day (including naps) |
| Children aged 1-2 years | 11-14 hours a day (including naps) |
| Children aged 3-5 years | 10-13 hours a day (including naps) |
| Children aged 6-12 years | 9-12 hours a day |
| Teens aged 13-18 years | 8-10 hours a day |
| Adults aged 18 years or older | 7–8 hours a day |
If an older adult has Alzheimer’s disease, it often changes their sleeping habits. Some people with Alzheimer’s disease sleep too much; others don’t sleep enough. Some people wake up many times during the night; others wander or yell at night. The person with Alzheimer’s disease isn’t the only one who loses sleep. Caregivers may have sleepless nights, leaving them tired for the challenges they face. Educate caregivers about these steps to promote safety for their loved one and help them and the client sleep better at night:
- Make sure the floor is clear of objects.
- Lock up any medications.
- Attach grab bars in the bathroom.
- Place a gate across the stairs.[8]
Diagnostic Tests
A sleep study may be ordered for a client suspected of having a sleep disorder. A sleep study monitors and records data during a client’s full night of sleep. A sleep study may be performed at a sleep center or at home with a portable diagnostic device. If done at a sleep center, the client will sleep in a bed at the sleep center for the duration of the study. Removable sensors are placed on the person’s scalp, face, eyelids, chest, limbs, and a finger to record brain waves, heart rate, breathing effort and rate, oxygen levels, and muscle movements before, during, and after sleep. There is a small risk of irritation from the sensors, but this will resolve after they are removed.[9] See Figure 12.10[10] of an image of a client with sensors in place for a sleep study.
Diagnoses
NANDA-I nursing diagnoses related to sleep include Disturbed Sleep Pattern, Insomnia, Readiness for Enhanced Sleep, and Sleep Deprivation.[11] When creating a nursing care plan for a client, review a nursing care planning source for current NANDA-I approved nursing diagnoses and interventions related to sleep. See Table 12.3c for the definition and selected defining characteristics of Sleep Deprivation.
Table 12.3c Sample NANDA-I Nursing Diagnosis Related to Sleep Deprivation[12]
| NANDA-I Diagnosis | Definition | Selected Defining Characteristics |
|---|---|---|
| Sleep Deprivation | Prolonged periods of time without sustained natural, periodic suspension of relative consciousness that provides rest. | Anxiety
Apathy Combativeness Confusion Decreased functional ability Prolonged reaction time Drowsiness Fatigue Hallucinations Heightened sensitivity to pain Irritable mood Transient paranoia |
A sample nursing diagnostic statement is, “Sleep Deprivation related to an overstimulating environment as evidenced by irritability, difficulty concentrating, and drowsiness.”
Outcome Identification
An overall goal related to sleep is, “The client will awaken refreshed once adequate time is spent sleeping.”[13]
A sample SMART outcome is, “The client will identify preferred actions to ensure adequate sleep by discharge.”[14]
Planning Interventions
Evidence-based nursing interventions to enhance sleep are summarized in the following box.
Sleep Enhancement Interventions[15],[16]
- Adjust the environment (e.g., light, noise, temperature, mattress, and bed) to promote sleep
- Encourage the client to establish a bedtime routine to facilitate wakefulness to sleep
- Facilitate maintenance of the client’s usual bedtime routines during inpatient care
- Encourage elimination of stressful situations before bedtime
- Instruct the client to avoid bedtime foods and beverages that interfere with sleep
- Encourage limitation of electronic devices before bedtime (e.g., phone, computer, television)
- Encourage the client to limit daytime sleep and participate in activity, as appropriate
- Bundle care activities to minimize the number of awakenings by staff to allow for sleep cycles of at least 90 minutes
- Consider sleep apnea as a possible cause and notify the provider for a possible referral for a sleep study when daytime drowsiness occurs despite adequate periods of undisturbed night sleep
- Educate the client regarding sleep-enhancing techniques
Transforming Hospitals Into Restful Environments to Promote Healing
Nurses nationwide have been researching innovative ways to transform hospitals into more restful environments that promote healing. As reported in the American Nurse, strategies include using red lights at night to reduce light exposure, reducing environmental noise, bundling care, offering sleep aids, and providing clienteducation[17]:
- Switching to Red Lights: Nurses can use red lights when providing care at night. Adult and pediatric clients were found to sleep better with reduced white lights.
- Reduce Environmental Noise: Clients were surveyed regarding factors that affected their ability to sleep, and results indicated bed noises, alarms, squeaking equipment, and sounds from other clients. Noise can be reduced by replacing the wheels on the trash cans and squeaky wheels on chairs, repairing malfunctioning motors on beds, switching automatic paper towel machines in the hallways with manual ones, and altering the times floors are buffed. Visitor rules can be implemented, such as no overnight stays in semiprivate rooms and overnight visitors in private rooms were asked to not use their cell phones, turn on the TV, or use bright lights at night.
- Bundling Care: Nurses reinforce bundling care by interdisciplinary team members to reduce sleep interruptions. For example, a “Quiet Time” policy can be set from midnight to 5 a.m. Quiet Time includes dimming lights, closing client room doors, and talking in lower voices.
- Offering Sleep Aids: Nurses can ask clients about what aids they use at home to help them sleep, such as extra pillows or listening to music. On admission, sleep kits can be provided with ear plugs and eye masks and at bedtime, warm washcloths can be offered to clients for comfort.
- Client Education: Clients and families can be provided with printed materials on the benefits of sleep and rest for optimal healing, participating in rehabilitative therapies, and prevention of delirium.
Pharmacological Interventions
See specific information about medications used to facilitate sleep in the previous “Sleep Disorders” section of this chapter.
Implementing Interventions
When implementing interventions to promote sleep, it is important to customize them according to the specific client’s needs and concerns. If medications are administered to promote sleep, fall precautions should be implemented, and the nurse should monitor for potential side effects, such as dizziness, drowsiness, worsening of depression or suicidal thoughts, or unintentionally walking or eating while asleep.
Evaluation
When evaluating the effectiveness of interventions, start by asking the client how rested they feel upon awakening. Determine the effectiveness of interventions based on the established SMART outcomes customized for each client situation.
Client Scenario
Mrs. Salvo is a 65-year-old woman admitted to the hospital for a gastrointestinal (GI) bleed. She has been hospitalized for three days on the medical-surgical floor. During this time, she has received four units of PRBCs, has undergone a colonoscopy and an upper GI series, and had hemoglobin levels drawn every four hours. The nurse reports to the client’s room to conduct an assessment prior to beginning the 11 p.m.-7 a.m. shift.
Although Mrs. Salvo’s hemoglobin has stabilized for the last 24 hours, Mrs. Salvo appears fatigued with bags under her eyes. In conversation with her, she yawns frequently and wanders off in her train of thought. She reports, “You can’t get any rest in here. I am poked and prodded at least once an hour.”
Applying the Nursing Process
Assessment: The nurse notes that Mrs. Salvo has bags under her eyes, is yawning frequently, reports difficulty achieving rest, and seems to have difficulty following the conversation.
Based on the assessment information that has been gathered, the following nursing care plan is created for Mrs. Salvo:
Nursing Diagnosis: Disturbed Sleep Pattern related to interruptions for therapeutic monitoring as evidenced by reports of difficulty achieving rest, bags under eyes, frequent yawning, and difficulty following conversation.
Overall Goal: The client will demonstrate improvement in sleeping pattern.
SMART Expected Outcome: Mrs. Salvo will report feeling more rested on awakening within 24 hours.
Planning and Implementing Nursing Interventions:
The nurse will assess the client’s sleep pattern and therapeutic monitoring disturbances. The nurse will group lab draws, vital signs, assessments, and other care tasks to decrease sleep disruption. The nurse will ensure the client’s door is closed and lighting is turned down to create a restful environment. The nurse will complete as many tasks as possible when Mrs. Salvo is awake and advocate with the interprofessional team for uninterrupted periods of rest during the night.
Sample Documentation:
Mrs. Salvo has a disturbed sleep pattern due to frequent therapeutic monitoring. Mrs. Salvo reports difficulty achieving rest, and despite stabilization in hemoglobin level, continues to demonstrate signs of fatigue. Interventions have been implemented to group therapeutic care to minimize disruption to the client’s sleep.
Evaluation:
The following morning, Mrs. Salvo reports improved sleep and feeling more rested with fewer awakenings throughout the night. SMART outcome "met."
Learning Activities
(Answers to “Learning Activities” can be found in the “Answer Key” at the end of the book. Answers to interactive activity elements will be provided within the element as immediate feedback.)
Scenario A
A nurse is caring for a client who has been hospitalized after undergoing hip-replacement surgery. The client complains of not sleeping well and feels very drowsy during the day.
- What factors are affecting the client’s sleep pattern?
- What assessments should the nurse perform?
- What SMART outcome can be established for this client?
- Outline interventions the nurse can implement to enhance sleep for this client.
- How will the nurse evaluate if the interventions are effective?
Scenario B
A nurse is assigned to work rotating shifts and develops difficulty sleeping.
- Why do rotating shifts affect a person’s sleep pattern?
- What are the symptoms of insomnia?
- Describe healthy sleep habits the nurse can adopt for more restful sleep.
Test your knowledge using this NCLEX Next Generation-style bowtie question. You may reset and resubmit your answers to this question an unlimited number of times.[18]
Circadian rhythms: Body rhythms that direct a wide variety of functions, including wakefulness, body temperature, metabolism, and the release of hormones. They control the timing of sleep, causing individuals to feel sleepy at night and creating a tendency to wake in the morning without an alarm. (Chapter 12.2)
Insomnia: A common sleep disorder that causes trouble falling asleep, staying asleep, or getting good quality sleep. Insomnia interferes with daily activities and causes the person to feel unrested or sleepy during the day. Short-term insomnia may be caused by stress or changes in one’s schedule or environment, lasting a few days or weeks. Chronic insomnia occurs three or more nights a week, lasts more than three months, and cannot be fully explained by another health problem or a medicine. Chronic insomnia raises the risk of high blood pressure, coronary heart disease, diabetes, and cancer. (Chapter 12.2)
Microsleep: Brief moments of sleep that occur when a person is awake. A person can't control microsleep and might not be aware of it. (Chapter 12.2)
Narcolepsy: An uncommon sleep disorder that causes periods of extreme daytime sleepiness and sudden, brief episodes of deep sleep during the day. (Chapter 12.2)
Non-REM sleep: Slow-wave sleep when restoration takes place and the body’s temperature, heart rate, and oxygen consumption decrease. (Chapter 12.2)
Obstructive sleep apnea (OSA): A common sleep condition that occurs when the upper airway becomes repeatedly blocked during sleep, reducing or completely stopping airflow. If the brain does not send the signals needed to breathe, the condition may be called central sleep apnea. (Chapter 12.2)
REM sleep: Rapid eye movement (REM) sleep when heart rate and respiratory rate increase, eyes twitch, and brain activity increases. Dreaming occurs during REM sleep, and muscles become limp to prevent acting out one’s dreams. (Chapter 12.2)
Sleep diary: A record of the time a person goes to sleep, wakes up, and takes naps each day for 1-2 weeks. Timing of activities such as exercising and drinking caffeine or alcohol are also recorded, as well as feelings of sleepiness throughout the day. (Chapter 12.2)
Sleep study: A diagnostic test that monitors and records data during a client’s full night of sleep. A sleep study may be performed at a sleep center or at home with a portable diagnostic device. (Chapter 12.2)
Sleep-wake homeostasis: The homeostatic sleep drive keeps track of the need for sleep, reminds the body to sleep after a certain time, and regulates sleep intensity. This sleep drive gets stronger every hour a person is awake and causes individuals to sleep longer and more deeply after a period of sleep deprivation. (Chapter 12.2)
Circadian rhythms: Body rhythms that direct a wide variety of functions, including wakefulness, body temperature, metabolism, and the release of hormones. They control the timing of sleep, causing individuals to feel sleepy at night and creating a tendency to wake in the morning without an alarm. (Chapter 12.2)
Insomnia: A common sleep disorder that causes trouble falling asleep, staying asleep, or getting good quality sleep. Insomnia interferes with daily activities and causes the person to feel unrested or sleepy during the day. Short-term insomnia may be caused by stress or changes in one’s schedule or environment, lasting a few days or weeks. Chronic insomnia occurs three or more nights a week, lasts more than three months, and cannot be fully explained by another health problem or a medicine. Chronic insomnia raises the risk of high blood pressure, coronary heart disease, diabetes, and cancer. (Chapter 12.2)
Microsleep: Brief moments of sleep that occur when a person is awake. A person can't control microsleep and might not be aware of it. (Chapter 12.2)
Narcolepsy: An uncommon sleep disorder that causes periods of extreme daytime sleepiness and sudden, brief episodes of deep sleep during the day. (Chapter 12.2)
Non-REM sleep: Slow-wave sleep when restoration takes place and the body’s temperature, heart rate, and oxygen consumption decrease. (Chapter 12.2)
Obstructive sleep apnea (OSA): A common sleep condition that occurs when the upper airway becomes repeatedly blocked during sleep, reducing or completely stopping airflow. If the brain does not send the signals needed to breathe, the condition may be called central sleep apnea. (Chapter 12.2)
REM sleep: Rapid eye movement (REM) sleep when heart rate and respiratory rate increase, eyes twitch, and brain activity increases. Dreaming occurs during REM sleep, and muscles become limp to prevent acting out one’s dreams. (Chapter 12.2)
Sleep diary: A record of the time a person goes to sleep, wakes up, and takes naps each day for 1-2 weeks. Timing of activities such as exercising and drinking caffeine or alcohol are also recorded, as well as feelings of sleepiness throughout the day. (Chapter 12.2)
Sleep study: A diagnostic test that monitors and records data during a client’s full night of sleep. A sleep study may be performed at a sleep center or at home with a portable diagnostic device. (Chapter 12.2)
Sleep-wake homeostasis: The homeostatic sleep drive keeps track of the need for sleep, reminds the body to sleep after a certain time, and regulates sleep intensity. This sleep drive gets stronger every hour a person is awake and causes individuals to sleep longer and more deeply after a period of sleep deprivation. (Chapter 12.2)
Learning Objectives
- Identify factors putting clients at risk for mobility problems
- Identify cues related to mobility problems
- Identify the effects of immobility on body systems
- Describe nursing interventions to prevent complications of immobility
- Contribute to a plan of care for clients with mobility alterations
Sit on a sturdy chair with your legs and arms stretched out in front of you, and then try to stand. This basic mobility task can be impaired during recovery from major surgery or for clients with chronic musculoskeletal conditions. Mobility, which includes moving one’s extremities, changing positions, sitting, standing, and walking, helps avoid degradation of many body systems and prevents complications associated with immobility. Nurses assist clients to be as mobile as possible, based on their individual circumstances, to achieve their highest level of independence, prevent complications, and promote a feeling of well-being. This chapter will discuss nursing assessments and interventions related to promoting mobility.
Learning Objectives
- Identify factors putting clients at risk for mobility problems
- Identify cues related to mobility problems
- Identify the effects of immobility on body systems
- Describe nursing interventions to prevent complications of immobility
- Contribute to a plan of care for clients with mobility alterations
Sit on a sturdy chair with your legs and arms stretched out in front of you, and then try to stand. This basic mobility task can be impaired during recovery from major surgery or for clients with chronic musculoskeletal conditions. Mobility, which includes moving one’s extremities, changing positions, sitting, standing, and walking, helps avoid degradation of many body systems and prevents complications associated with immobility. Nurses assist clients to be as mobile as possible, based on their individual circumstances, to achieve their highest level of independence, prevent complications, and promote a feeling of well-being. This chapter will discuss nursing assessments and interventions related to promoting mobility.
