Purpose

• Ambulation is the act of walking. Some people are weak and unsteady from bedrest, illness, surgery, or injury. They need help walking.
• After bedrest, activity increases slowly and in steps. First the person sits on the side of the bed (dangles). Sitting in a bedside chair follows. Next the person walks in the room and then in the hallway. This is true whether the patient walks with or without a gait belt or with a walking aid, such as a cane, a walker, crutches, or a brace.
• Follow the care plan when helping a person walk. Use a gait (transfer) belt if the person is weak or unsteady. The person also uses hand rails along the wall. Always check for orthostatic hypotension--weakness, dizziness, spots before the eyes, feeling faint.
• Walking aids support the body. The type ordered depends on the person’s condition, the support needed, and the disability. The physical therapist measures and teaches the person to use the device.

Equipment

Roll cursor over items to see labels. For the purposes of clearly depicting the equipment, a barrier is not shown in this photo. When providing care, a barrier should always be placed on the surface before placing the equipment.

Paper to protect bottom linens

Robe

Non-skid shoes

Gait (transfer) belt

Wheeled walker

Walker

Cane

Delegation

Follow delegation guidelines. Before helping the person walk, obtain this information from the nurse and care plan:

• How much help the person needs
• If the person uses a cane, a walker, crutches, or a brace
• Areas of weakness—right arm or leg, left arm or leg
• How far to walk
• What observations to report and record
• When to report observations
• What patient or resident concerns to report at once

Preparation

• Observe quality-of-life measures.
• Review the information under Delegation and Safety and Comfort.
• Collect the equipment.
• Practice hand hygiene.
• Identify the person. Check the ID bracelet against the assignment sheet. Also call the person by name.
• Provide for privacy.

Safety

• Practice safety measures to help prevent falls.
• Use a gait belt to help the person stand. Also use it during ambulation.
• Remind the person to walk normally.
  • Encourage the person to stand erect with the head up and the back straight.
  • Discourage shuffling, sliding, and walking on tip-toes.
• If crutches are used, check the tips, which must not be worn down, torn, or wet. Check crutches for flaws and tighten all bolts. Have the person wear street shoes and clothes that fit well. Keep crutches within the person’s reach.
• If a wheeled walker is used, move the wheels to the inside of the walker, if needed, to fit through narrow doorways. If the walker has a seat, never push the walker when the person is seated.

Comfort

The fear of falling affects mental comfort. Explain the purpose of the gait belt. Also explain how you will help the person if he or she starts to fall.

Follow-up Care

• Provide for comfort.
• Place the call light within reach.
• Raise or lower the bed rails. Follow the care plan.
• Return the robe and shoes to their proper place. If a walking device was used, put it near the person.
• Unscreen the person.
• Complete a safety check of the room.
• Practice hand hygiene.

Reporting/Recording

Report and record your observations, including:

• How well the person tolerated the activity
• Shuffling, sliding, limping, or walking on tip-toes
• Complaints of pain or discomfort
• Complaints of orthostatic hypotension—weakness, dizziness, spots before the eyes, feeling faint
• The distance walked