Self-Care Deficit (Pediatric Inpatient)
Clinical Description
- Care of the hospitalized child experiencing limitations in the safe and independent performance of activities of daily living.
Key Information
- It is important to consider the child’s and family’s cultural norms, along with individual priorities and preferences when promoting self-care performance.
- Early rehabilitation and care aimed at increasing self-care abilities are important to help prevent loss of independence and associated negative health outcomes.
Clinical Goals
By transition of care
A. The patient will achieve the following goals:
B. Patient, family or significant other will teach back or demonstrate education topics and points:
- Education: Overview
- Education: Self Management
- Education: When to Seek Medical Attention
Self-Care Deficit
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.
- Activity Assistance Provided
- Adaptive Equipment Use
- Self-Care Promotion
Education
Overview
risk factors
signs/symptoms
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
References
- (2018). Butcher, H. K.; Bulecheck, G. M.; Dochterman, J. M.; Wagner, C. M. (Eds.), Nursing interventions classifications (NIC). St. Louis: Elsevier. [Review Articles,Expert/Committee Opinion,Core Curriculum,Position Statements,Practice Bulletins]
- Case-Smith, J.; O'Brien, J. C. (2015). Occupational therapy for children and adolescents. St. Louis: Mosby, Elsevier. [Review Articles,Expert/Committee Opinion,Core Curriculum,Position Statements,Practice Bulletins]
- Gronski, M.; Doherty, M . Interventions within the scope of Occupational Therapy practice to improve activities of daily living, rest, and sleep for children ages 0–5 Years and their families: A systematic review. 2020;74(2), 10-33. doi:10.5014/ajot.2020.039545 [Systematic Review]
- Haugen, N.; Galura, S. (2020). Ulrich and Canale's Nursing Care Planning Resource-E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health. St. Louis: Saunders, Elsevier. [Review Articles,Expert/Committee Opinion,Core Curriculum,Position Statements,Practice Bulletins]
- Hockenberry, M. J.; Wilson, D.; Rodgers, C. C. (2019). Wong's nursing care of infants and children. St. Louis: Mosby, Elsevier. [Review Articles,Expert/Committee Opinion,Core Curriculum,Position Statements,Practice Bulletins]
- Palisano, R. J.; Orlin, M. N.; Schreiber, J. (2017). Campbell's physical therapy for children. St. Louis: Elsevier. [Review Articles,Expert/Committee Opinion,Core Curriculum,Position Statements,Practice Bulletins]
- Registered Nurses' Association of Ontario. (2015). Person- and family-centred care. Source[Quality Measures,Clinical Practice Guidelines]
- Swearingen, P. L.; Wright, J. (2019). All-in-One Nursing Care Planning Resource-E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health. Philadelphia: Elsevier Health Sciences. [Review Articles,Expert/Committee Opinion,Core Curriculum,Position Statements,Practice Bulletins]
Disclaimer
Clinical Practice Guidelines represent a consistent/standardized approach to the care of patients with specific diagnoses. Care should always be individualized by adding patient specific information to the Plan of Care.