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Care Plan

ThomasRECOM Care Plan

INNOboot Regular, Jumbo and Pediatric.

Goal: The INNOboot is designed for hospital and nursing home environment where long or short term usage is required. The INNOboot has a washable liner. It provides an effective treatment and restorative/corrective system for multiple lower extremity disorders secondary to immobility complications and neuromuscular deficit.

Nursing diagnosis: Foot-drop, internal/external rotation of the hip, leg, knee and foot, Plantar faciitis, pressure ulcers of the foot, ankle, toes or heel.

Nursing Intervention Foot-drop:

  1. Perform passive range of motion to affected extremity as a prescribed by physician or therapy order.
  2. Bring foot into alignment.
  3. Apply INNOBOOT orthosis as described in application direction.
  4. Check for correct placement of heel.
  5. Check for excessive strap measure.
  6. Wear 2 hours on, 2 hours off as tolerated to begin or as instructed by physician or therapy order.
  7. Increase weaning time by ½ to 1 hour according to patient’s tolerance until orthosis is being used 4 hours on ½ hour off, or as prescribed by physician or therapy order.
  8. Check skin integrity carefully each time orthosis is removed if redness persists beyond time off period leave orthosis off until redness disappears and reduce time only 1 hour.
  9. Passively stretch extremity each time before application.
  10. Document progress in chart.

 INTERNAL/EXTERNAL ROTATON OF HIP, LEG KNEE, FOOT

  1. Follow steps 1 through 8 as for foot-drop.
  2.  Position rotator bar as indicated for lateral stabilization (patient in supine position)
  3. Remove orthosis for ½ hour and reapply, or as directed by physician or therapy order
  4. Passively stretch extremity each time before application.
  5. Document progress in chart

PRESSURE UNLCERS OF THE FOOT, ANKLE TOE OR HEEL

1.      Follow steps 1 through 8 as for foot-drop

2.      Turn and position patient at least 2 deg

3.      Position toe post and rotator bar as indicated by patient’s condition to relieve pressure of affected       area.

4.      Remove orthosis for ½ hour and reapply. Or as directed by physician or therapy order.

5.      Document progress in chart

CONCERNS:

  1. For correct fit the patient’s sole should make contact with the orthosis with a finger’s length space between heel and orthosis.
  2. Exercise tightness precautions- do not apply softgoods to tightly, there should be a fingers width of space under all softgoods.
  3.  Build wearing time gradually as patient tolerates, if any redness or pain is experienced, remove orthosis for 2 hours and reapply.
  4. Check skin integrity each time orthosis is removed, if redness persists beyond 2 hours don’t reapply – contact nursing.

EXPECTED OUTCOME

  1. Correct foot-drop or foot/ankle contractures.
  2.  Maintain functional alignment of foot, ankle, leg.
  3. Increase mobility.
  4. Relieve pressure.
  5. Prevent permanent deformity.