traction protocols

[mmc51264, BSN, MSN, RN]

Do you have a set of policies and protocols in your facility about traction? I have seen 2 in the last two weeks where veteran, certified nurses seem to be ignoring what is, I thought, pretty standard protocols. Someone monitoring weights with transport and how to handle when changing position in bed. That sort of thing.

[Colorado1]

I don't see traction ordered very much anymore. Our hip fractures usually get an ORIF or TH by the next day so we reposition gently and keep a large ice bag next to the hip.

[mmc51264, BSN, MSN, RN]

Depending on OR schedule, ours can wait up to 2 days. It was kind of a fluke that we had 2 tractions in 2 weeks. The last one was due to decompressing the ED. traumas go to OR first. We had 106 in the ED waiting for beds that weekend.

[kgoode0919]

Yep, we have protocols. It doesn't mean that they are always followed. If I followed every single policy for all of my patients, then I would work 24 hr shifts (the last 12 hrs spent charting). Our policy is to wash the limb and completely dry before placing traction. Every two hours the traction is to be released; check for pulses, skin breakdown, knots and bolts tightened, knots secured with tape.....

[BonerRN]

Could you expand on what policies and protocols the nurses did not follow. We have buck's traction at least once a week. Have had two skeletal tractions this year. That is a lot of ER holds, what State are you in. Do you have to go to the ER to help with overflow/ortho patients.

thanks

[mmc51264, BSN, MSN, RN]

No, we do not go to ED, we have residents that do all that stuff. I am in NC at a huge Level one Hosp

I am talking transportation with traction. More than once I see the weights swinging in the air. We have also had problems where the weights are not hung high enough because docs raise bed to apply, but them when you put the bed back down to safe level, the weights hit the floor!. We do NOT release traction ever! you can check for a pulse with traction on.

Not all hips get traction, but we do get some. I don't know what the protocols are for application. Most get applied in the ED.

We haven't had any in a while, so I have to go back and look if I can find anything

[BonerRN]

Weights swinging going down the hall is a big pet peewe, that I talk about in the new hire orientaion class, that and the classic foley bag in the lap or on chest while on stretcher. I am at a level 2 trauma center. Thanks