turning hip joint replacement pts.

[fiona]

I would be interested to hear the protocols of other hospitals around the world regarding turning a post-op total hip joint replacement. Do you use pillow or special wedge to keep legs abducted? How many nurses to turn? How often do you turn?

[justanurse]

Well, it's been a few years since I did orthopedics. We always used the abduction pillow, for any total or bi-polar hips. If it was a hip pinning, we didn't use the pillows unless the patients were put on total hip precautions (as per written order). It will usually take at least two to turn (one to turn and one to place pillows behind, as most patients can use their arms to help pull with the bedrail. Patients should be turned q2hours as per post-op routine.

I'm from the mid-west of the USA. Hope this information helps.

[rachelmorgan]

Originally posted by fiona:

I would be interested to hear the protocols of other hospitals around the world regarding turning a post-op total hip joint replacement. Do you use pillow or special wedge to keep legs abducted? How many nurses to turn? How often do you turn?

[rachelmorgan]

To prevent dislocation, the limb should not be internally rotated and the hip flexed at the same time. A pillow is placed between the patients legs when rolling by 2 nurses. A charnley wedge is used for revision patients.

Originally posted by fiona:

I would be interested to hear the protocols of other hospitals around the world regarding turning a post-op total hip joint replacement. Do you use pillow or special wedge to keep legs abducted? How many nurses to turn? How often do you turn?

[mfb1960]

Hi we always use an abduction pillow to turn our THR. Our patients are also advised to use a pillow at home. Good luck

Mark

[joe34]

Hi Fiona,

I am a junior BSN student. I am also a licensed Phyisical Therapist Assistant and have worked in a hospital with a large orthopedic caseload for the past six years. We have two THR protocals. The first being the traditional posterior approach precations of avoiding hip flexion greater than 90 degrees, internal rotation, and adduction. The second is for an anterior approach THR which the surgeons are using more often due to decreased dislocations. The precautions for this are avoidance of hip extension, external rotation, and adduction. This doesn't alleviate the use of a abduction wedge during turning, but the nurses like it better because they only have to worry about the adduction precation and not flexion or IR.