Chapter 3. Safer Patient Handling, Positioning, Transfers and Ambulation
Chapter 3. Safer Patient Handling, Positioning, Transfers and Ambulation
3.10 Assisting a Patient to Ambulate Using Assistive Devices
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 improves emotional and social well-being (Kalisch, Lee, & Dabney, 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.
Before ambulating, the patient may need assistance getting to a sitting position.
Assisting Patient to the Sitting Position
Patients 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 et al., 2017). 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 29 outlines the steps to positioning the patient on the side of a bed prior to ambulation (Perry et al., 2018).
Checklist 29: Assisting a Patient to a Sitting PositionDisclaimer: Always review and follow your agency policy regarding this specific skill. |
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Safety considerations:
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Steps |
Additional Information |
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| 1. Check prescriber’s orders for any restrictions related to ambulation due to medical treatment or surgical procedure. | Equipment (proper footwear, gait belt, or assistive devices) must be gathered prior to ambulation. Do not leave patient sitting on the side of the bed unsupervised, as this poses a safety risk. | ||
| 2. Explain what will happen and let the patient know how they can help. | This step provides the patient with an opportunity to ask questions and help with the positioning. | ||
| 3. Lower bed and ensure brakes are applied. | This prepares the work environment. | ||
| 4. Stand facing the head of the bed at a 45-degree angle with your feet apart, with one foot in front of the other. Stand next to the waist of the patient. | Proper positioning helps prevent back injuries and provides support and balance. | ||
| 5. Have pati