Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

Skill Checklists for Taylor's Clinical Nursing Skills:
A Nursing Process Approach, 3rd edition

Name Date

Unit Position

Instructor/Evaluator: Position

SKILL 9-20

Caring for a Patient With an External Fixation Device

Goal:The patient shows no evidence of complication, such as

infection, contractures, venous stasis, thrombus formation, or

skin breakdown. Comments

1. Review the medical record and the nursing plan of care to
   determine the type of device being used and prescribed
   care.


2. Perform hand hygiene. Put on PPE, as indicated.


3. Identify the patient. Explain the procedure to the patient.
   Assure the patient that there will be little pain after the fix-
   ation device is in place. Reinforce that the patient will be
   able to adjust to the device and will be able to move about
   with the device, allowing him or her to resume normal
   activities more quickly.
   4.After the fixation device is in place, apply ice to the surgi-
   cal site, as ordered or per facility policy. Elevate the
   affected body part, if appropriate.


4. Perform a pain assessment and assess for muscle spasm.
   Administer prescribed medications in sufficient time to
   allow for the full effect of the analgesic and/or muscle
   relaxant.


5. Administer analgesics, as ordered, before exercising or
   mobilizing the affected body part.


6. Perform neurovascular assessments, per facility policy or
   physician’s order, usually every 2 to 4 hours for 24 hours,
   then every 4 to 8 hours. Assess the affected body part for
   color, motion, sensation, edema, capillary refill, and pulses.
   If appropriate, compare with the unaffected side. Assess for
   pain not relieved by analgesics, and for burning, tingling,
   and numbness.


7. Close curtains around bed and close the door to the room,
   if possible. Place the bed at an appropriate and comfortable
   working height, usually elbow height of the caregiver (VISN
   8 Patient Safety Center, 2009).


8. Assess the pin site for redness, tenting of the skin,
   prolonged or purulent drainage, swelling, and bowing,
   bending, or loosening of the pins. Monitor body
   temperature.

ExcellentSatisfactoryNeeds Practice