Ambulation, Transfers and Mobility Devices

Preparation, Safety Principles, and Gait Belt Application

Assisting a resident with walking begins with careful preparation to ensure safety and comfort. Before starting, the nurse aide must check the care plan for the prescribed ambulation distance and the required level of assistance. The nurse aide must also inspect the physical environment, ensuring walkways are cleared of clutter, cords, throw rugs, and spills prior to ambulation. The resident must wear non-skid footwear before standing or walking to prevent slipping. Ensuring a clear path and proper footing provides a secure foundation for movement.

Rushing a resident from a lying position directly to standing can cause sudden discomfort. To prevent complications, the nurse aide allows the resident to sit at the edge of the bed before standing. While the resident is dangling their legs, the nurse aide watches closely for dizziness or lightheadedness and actively asks the resident if they feel dizzy or lightheaded before proceeding. For example, pausing at the bedside gives the resident's body time to adjust, just as a person pauses on the edge of the bed after waking up.

A gait belt is an essential safety tool used during ambulation and transfers. It is applied snugly around the resident's waist over clothing, and never over bare skin. The gait belt is properly fitted when two flat fingers can fit comfortably between the belt and the resident's body. However, a gait belt is not placed over surgical incisions, colostomies, feeding tubes, or broken ribs. When assisting the resident, the nurse aide grasps the gait belt using an underhand (supinated) grip. The nurse aide does not pull or drag the resident upward by the gait belt to force standing.