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PAGE 1SURNAME:FIRSTNAMES:DATE OFBIRTH:UpdatedJan 2017NHI:/Family members participating in Care Plan:/Please attach patientDate / GoalTimeFamily Centred CareSEXlabel:hereHalo Traction Care PlanExpected OutcomesIndividualised Care Needs Family are orientated to the area and facilities Families are enabled and encouraged to askquestions and participate in care Complete “My name is” poster at bedside Identify estimated discharge date Key family support member is identified anddocumented Identified social and cultural requirements Family have identified specific culturalconsiderations and they are in place Cultural support provided at family meetings Care is negotiated with caregivers on a shift byshift basis and family are aware of care plan Activities of daily living (ADLs) are planned dailywith families meeting the needs of the individualchild with consideration to development Families are fully conversant in all aspects oftheir child’s care and are fully prepared toconfidently care for child post dischargePain and comfortassessment andmanagement Identify child’s known response to pain andcomfort strategies Identify on a daily basis potential sources of painand discomfort including pre and post proceduralmanagementCR4514Halo TractionRevision, Date& Time, Name& SignatureSignatureNurse andFamily
PAGE 2SURNAME:FIRSTNAMES:DATE OFBIRTH:UpdatedJan 2017NHI:/Family members participating in Care Plan:/Please attach patientDate / GoalTimeSEXlabel:hereHalo Traction Care PlanExpected OutcomesIndividualised Care Needs Undertake pain assessment in discussion withchild and/or caregiver complimented with an ageappropriate pain scale Identify and implement any non-pharmacologicalapproaches or techniques Identify and administer appropriate analgesicrequirements Evaluate effectiveness of interventions andescalate further analgesic requirements Clinical care reviews provide the opportunity toassess pain on a regular basisChild will participate inactivities/playappropriate to theirdevelopmental level Explain all procedures to patient and family Where possible involve family in all cares Encourage patient to take control when possible(establishing care routines, dietary choices,activities) Position child to see surroundings and activities Involve play therapist/ adolescent play therapist Try to maintain a normal environment: Sleep Routine Own toys School Ensure call bell is within reach at all timesCR4514Halo TractionRevision, Date& Time, Name& SignatureSignatureNurse andFamily
PAGE 3SURNAME:FIRSTNAMES:DATE OFBIRTH:UpdatedJan 2017NHI:/Family members participating in Care Plan:/Please attach patientDate / GoalTimeMaintain regular bowelelimination patternMaintain skin integritySEXlabel:hereHalo Traction Care PlanExpected Outcomes Individualised Care NeedsInvolve dietician into child's care day 1 post-opMaintain strict FBC, including food recordEncourage oral intake of fluidsEncourage fruit, vegetables and high fibre dietRecord all bowel movements on chartGive prescribed laxatives regularly Refer to Guideline for Pressure Injury Preventionfor an Infant, Child or Young Person Complete Glamorgan paediatric pressure injuryrisk assessment scale and implement appropriateBundle of care Ensure regular change of position 2-3 hourly andrecord on chart Ensure all joints and limbs are in correctalignment Liaise with physiotherapists with cares includingR.O.M exercises and care of limbs Assist with ADLs daily Check traction integrity each shift, includingjacket if applicable Liaise with Orthotics for liner change if in a HaloJacket. Check for pressure areas under jacketMinimise and monitor forpotential complicationsCR4514 Clean pin-sites 48 hours post insertion then daily,assessing the pin-sites for signs of infection andHalo TractionRevision, Date& Time, Name& SignatureSignatureNurse andFamily
PAGE 4SURNAME:FIRSTNAMES:DATE OFBIRTH:UpdatedJan 2017NHI:/Family members participating in Care Plan:/Please attach patientDate / GoalTimewhile in halo traction. i.e.Infection and nerve palsyof sixth cranial nerveSEXlabel:hereHalo Traction Care PlanExpected OutcomesIndividualised Care Needsmovement Administer I.V. antibiotics as prescribed Ensure all weights are off the floor, if weights arerequired. Ensure the traction has the correctweight for the child. No more than 39% of thechild's body weight unless specified by theorthopaedic medical team Maintain counter traction by tilting the end ofthe bed facing downwards, against the weights Watch for signs of nerve palsy Speaking difficulties Dysphagia or Dysarthria Drooping tongue Report to team a.s.a.p. if signs of nerveDischarge planningand preparationpalsy noted Discuss with family on daily ward roundestimated date of discharge Assess discharge needs and supports with familyand MDT and begin preparation for dischargeearly including referrals, equipment, medicationsand education Infectious concerns Discuss implications with family for:oCR4514Return to school/early childhoodcenters/Kohanga ReoHalo TractionRevision, Date& Time, Name& SignatureSignatureNurse andFamily
PAGE 5SURNAME:FIRSTNAMES:DATE OFBIRTH:Date / GoalTimeUpdatedJan 2017NHI:/Family members participating in Care Plan:/Please attach patientSEXlabel:hereHalo Traction Care PlanExpected OutcomesIndividualised Care NeedsoReturning to normal level of dailyactivities (inclusive of group andcultural activities) Check immunisation status and opportunisticallyimmunise Arrange discharge meeting if required Educate family on normal course of illness,concerning signs and symptoms of recurrenceand how and where to seek help Follow up referrals and appointments specific topresentation: hearing assessmentCR4514Halo TractionRevision, Date& Time, Name& SignatureSignatureNurse andFamily
and MDT and begin preparation for discharge . Discuss implications with family for: o Return to school/early childhood centers/Kohanga Reo . CR4514 Halo Traction Halo Traction Care Plan SURNAME: FIRST NAMES: DATE OF BIRTH: NHI: SEX Please attach patient label here: / / Family members participating in Care Plan: PAGE 5 Updated
