Ambulation Devices- updated 2022(3).pdf

Nurse Aide Training Program MOBILITY AND AMBULATION TECHNIQUES  Objectives: The NA trainee will be able to: Identify the safety precautions involved in the use of wheelchairs Describe the types and purpose of lifts Identify safe and proper use of walkers, canes, and crutches Demonstrate...

Nurse Aide Training Program MOBILITY AND AMBULATION TECHNIQUES  Objectives: The NA trainee will be able to: Identify the safety precautions involved in the use of wheelchairs Describe the types and purpose of lifts Identify safe and proper use of walkers, canes, and crutches Demonstrate the safe way to assist a resident to walk  Wheelchair Safety Identify parts of wheelchair: Footrests Armrests Seat Brakes How to remove footrests How to collapse wheelchair Wheelchair Safety ◦ Check the brakes. Make sure you can lock and unlock them ◦ Check for flat or loose tires. A brake will not lock onto a flat or loose tire ◦ Make sure that wheel spokes are intact. Damaged, broken, or loose spokes can interfere with moving the wheelchair or locking the brakes ◦ Make sure casters point forward. This keeps the wheelchair balanced and stable ◦ Geriatric chairs and shower chairs are not designed to transport a resident  Wheelchair Safety Make sure the resident’s feet are on the footplates before pushing or repositioning the chair. The resident’s feet must not touch or drag on the floor when the chair is moving. Push the chair forward when transporting the resident. Do not pull the chair backward. Lock both brakes before you transfer a resident to or from the wheelchair. Wheelchair Safety Remind the resident to keep the brakes locked when not moving the wheelchair. The brakes prevent the chair from moving if the resident wants to move to or from the chair. Do not let the resident stand on the footplates. Do not let the footplates fall back onto the resident’s legs. Make sure the resident has needed wheelchair accessories per care plan. Wheelchair Safety Remove the armrests (if removable) when the resident transfers to the bed, commode, tub, or car. Remove the armrests (if removable) when lifting the resident from the chair. Swing front rigging out of the way for transfers to and from the wheelchair. Some front riggings detach for transfers. Wheelchair Safety Clean the wheelchair according to facility policy. Blankets and tubing should be kept away from the wheels. The wheelchair should be pushed from behind except when going in and out of elevators, then pull the wheelchair into and out of the elevator backwards. Wheelchair Safety When moving a resident down a steep ramp, you should take the wheelchair or geriatric chair down backwards. Glance over your shoulder to be sure of your direction and prevent collisions and possible falls. Slow down at corners and look before moving the wheelchair to prevent collisions with other residents, staff, etc. Use the wheelchair that has been designated as appropriate for the resident. Lifts: Types Manual or hydraulic lifts Electric lifts Assist to stand lift Many types of lifts and pads available Lifts: Purposes Lifts are used to move residents who cannot assist in their own transferring and/or for residents who are too heavy for the staff to lift safely. Lifts: Safety precautions  Make sure the lift works  Check weight limit of lift (and resident’s weight)  Make sure the sling, straps, hooks, and chains are in good repair  Never operate a mechanical lift without the assistance of another staff member. Safety requires that at least two people are present  Lifts :Safety precautions cont. Lock all brakes after positioning the lift (if applicable) Position sling pad (usually even with back of resident’s knee) or per directions Secure the resident in the straps or slings Ask resident to place arms across chest Raise lift slowly Open legs of lift before transfer (wide base of support) Reassure the resident while transferring Ambulation Devices: Safety concerns Devices used for walking should have skid-proof tips Residents should wear skid-proof shoes Follow plan of care to determine which device resident uses Use resident’s personal walker, cane, crutches Safety Devices: Walker Walkers: stand still, place the walker forward with all four legs solidly on the floor, step forward toward the walker, repeat Many types of walkers for different needs Practice: Walking Sitting down and standing up from a chair with a walker Assisting another to walk with a walker How to adjust height of a walker Safety Devices: Crutches Crutches: should have some space between the top of the crutch and axilla. The elbows should be flexed slightly, and the weight supported on palms of the hands Practice: ◦ Walking with crutches ◦ Adjusting crutches to fit Safety Devices: Canes Many types of canes Quad cane may be more stable for some conditions Cane is placed on strong or unaffected side Practice: Walking Adjusting cane In/out of chair Safety techniques: For walking the resident Resident should wear skid-proof shoes When assisting a resident to change position, move slowly to avoid dizziness and observe for signs of dizziness Assist on the resident’s weak side Have resident use their strong side for holding handrails or cane Safety techniques cont’d When assisting a visually impaired resident, walk slightly ahead and allow resident to hold your arm. Explain hazards in the path as necessary Use a transfer (gait) belt for safety Technique when assisting to walk Help the resident stand. Grasp the gait belt at each side Stand at the resident’s side while he or she gains balance. Hold the belt at the side and back. Encourage the resident to stand erect with the head up and back straight, with a broad base of support Help the resident walk. Walk to the side and slightly behind the resident. Provide support with the gait belt or have one arm around the back to support the resident Encourage the resident to walk normally. The heel strikes the floor first. Discourage shuffling, sliding, or walking on tiptoes