Self-Care Deficit (Pediatric Inpatient)

Signs/Symptoms/Presentation

• ability to perform developmentally-appropriate functional activity impaired
• active movement limitation
• bathing ability limited
• dressing ability limited
• grooming ability limited
• inability to complete BADLs (basic activities of daily living)
• inability to complete IADLs (instrumental activities of daily living)
• limited endurance
• muscle weakness
• pain limits activity
• reluctance to perform self-care
• requires assistance with self-care
• requires prompting to perform self-care
• self-feeding ability limited
• shortness of breath
• toileting ability limited

Problem Intervention

Promote Activity and Functional Independence

• Evaluate ability to perform and complete age-appropriate BADLs (basic activities of daily living) and IADLs (instrumental activities of daily living) safely and independently.
• Identify patient’s preferences for clothing, food and personal care items; offer and honor patient choice when possible.
• Provide therapeutic interventions, such as modifications or adaptations to personal care tasks or routines; individualize interventions to developmental need.
• Implement appropriate environmental modifications, such as reducing auditory and visual stimulation or adaptive seating for bathing.
• Encourage active participation and independence in daily activity; provide level of assistance required for safety.
• Promote use of recommended adaptive equipment, devices and orthoses.
• Maintain child or parent/caregiver’s preferred routines and habits; respect privacy and personal space.
• Schedule self-care activities when pain and fatigue are at a minimum to encourage optimal performance.
• Pace activity; allow adequate time and rest periods to conserve energy.
• Provide frequent encouragement, along with prompting and assistance as needed.
• Provide set-up of items if patient is unable to retrieve; store personal care items in accessible location.
• Individualize instructions and prompts to patient’s cognitive status to promote effective communication; simplify verbal directions, give encouragement and provide demonstrated cues as needed.
• Position the patient for optimal performance, such as sitting in a chair for meals or performing hygiene at sink.

Associated Documentation

• Activity Assistance Provided
• Adaptive Equipment Use
• Self-Care Promotion

Overview

Self Management

When to Seek Medical Attention

General Education

• admission, transition of care

• orientation to care setting, routine

• advance care planning

• diagnostic tests/procedures

• diet modification

• opioid medication management

• oral health

• medication management

• pain assessment process

• safe medication disposal

• tobacco use, smoke exposure

• treatment plan

Safety Education

• call light use

• equipment/home supplies

• fall prevention

• harm prevention

• infection prevention

• MDRO (multidrug-resistant organism) care

• personal health information

• resources for support