Chapter 3. Safe Patient Handling, Positioning, and Transfers Show Immobility in hospitalized patients is known to cause functional decline and complications affecting the respiratory, cardiovascular, gastrointestinal, integumentary, musculoskeletal, and renal systems (Kalisch, Lee, & Dabney, 2013). For surgical patients, early ambulation is the most significant factor in preventing complications (Sanguinetti, Wild, & Fain, 2014). Lack of mobility and ambulation can be especially devastating to the older adult when the aging process causes a more rapid decline in function (Graf, 2006). Ambulation provides not only improved physical function, but also improved emotional and social well-being (Kalisch et al., 2013). Prior to assisting a patient to ambulate, it is important to perform a patient risk assessment to determine how much assistance will be required. An assessment can evaluate a patient’s muscle strength, activity tolerance, and ability to move, as well as the need to use assistive devices or find additional help. The amount of assistance will depend on the patient’s condition, length of stay and procedure, and any previous mobility restrictions. Assisting Patient to the Sitting PositionPatients who have been immobile for a long period of time may experience vertigo, a sensation of dizziness, and orthostatic hypotension, a form of low blood pressure that occurs when changing position from lying down to sitting, making the patient feel dizzy, faint, or lightheaded (Potter, Perry, Ross-Kerr, & Wood, 2010). For this reason, always begin the ambulation process by sitting the patient on the side of the bed for a few minutes with legs dangling. Checklist 27 outlines the steps to positioning the patient on the side of a bed prior to ambulation (Perry, et al., 2014). Checklist 27: Assisting a Patient to a Sitting Position
Video 3.2Ambulating a PatientAmbulation is defined as moving a patient from one place to another (Potter et al., 2010). Once a patient is assessed as safe to ambulate, determine if assistance from additional health care providers or assistive devices is required. Checklist 28 reviews the steps to ambulating a patient with and without a gait belt. Checklist 28: Ambulating a Patient
Video 3.3Video 3.4Watch the video How to Ambulate with a Cane by Kim Morris of Thompson Rivers University. Video 3.5Watch a video How to Ambulate With Crutches by Kim Morris, Thompson Rivers University.
Why should a nurse use a gait belt?A gait belt is a device that helps to prevent falls. A weakened person, such a patient in the hospital, is at risk for falls while walking or moving from a bed to a chair or from sitting to standing.
When assisting a client with ambulation using a gait belt you should be?Stand in front of the patient, grasping each side of the gait belt, keeping back straight and knees bent. The patient must be cooperative and predictable, able to bear weight on own legs, and have good trunk control. 4. While holding the belt, gently rock back and forth three times.
What is the purpose of a gait belt quizlet?A gait belt is used to transfer a patient safely or as a safety measure to steady a patient who has poor balance. NAP or nurses may use a gait belt.
On which side of the client should the nurse be when ambulating with a gait belt?The nurse will apply a gait belt for patient safety, and stand on the patient's weak side.
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