Patient Ambulation Assistance

Clients may require assistance in moving up, sitting down, or sitting at the edge of a bed.

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Assessments

1. Check the client’s physical abilities: muscle strength, paralysis, skin traction, and casted extremities.
2. Ability of the client to understand instructions.
3. Client’s weight and the caregiver’s strength and ability to move the client.
4. Medications the client is receiving, such as those that produce drowsiness or sleepiness.

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Procedure

1. Greet and identify the client.
2. Explain the procedures to be performed.
3. Adjust the positions of attachments; IV poles, tubes, catheters, etc.
4. Provide the client with hearing aids and glasses if used.
5. Lower the head of the bed to the lowest position. Lock the wheels of the bed to avoid it moving during the procedure, and place the pillow the near the headboard.
6. Assist the client to a supine position with knees flexed with at least one sole of the patient’s feet flat on the bed.
7. A trapeze may be used if present (often in geriatrics, stroke patients, parkinsons, muscular dystrophic patients.
8. Seat the patient in bed and turn to the side (or done in one motion) of the bed.
9. Transferring Clients from a Bed to Wheelchair
   • Verify orders, greet and identify client, obtain vital signs (for orthostatic hypotension)
   • Position the wheelchair on the stronger side of the patient.
   • The side rail on the opposing side of the bed should be up. The wheelchair should be on the same level as the bed.
   • Apply a transfer belt with an allowance of three finger breadths. You may use a pull sheet instead of a transfer belt, tied around the waist of the patient with the same allowance. It should be grabbed hands down grasping around the pull sheet and not from under.
   • Give footwear for the patients.
   • Place the dominant right in between the patient’s feet, hands grabbing the transfer belt, and have the patient hold the nurse’s shoulders.
   • Slowly move the patient to the wheelchair, seated in a comfortable position.
   • Remove the transfer belt and provide draping for the patient.
   • Place the patient’s feet on the footplate of the wheelchair.
   • Unlock the wheelchair and move the patient. When exiting doors, the caregiver always leads.
10. Transferring Clients from a Wheelchair to a Bed
    • Remove the drapes.
    • The strong side of the patient should be closer to the bed.
    • Apply the transfer belt on the patient.
    • Perform the same maneuver as earlier.
    • Turn the patient and sit them at the edge of the bed.
    • Remove the transfer belt and footwear.
    • Sit the patient down.
    • Wait for 10 minutes and check the patient’s vital signs.

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Types of Paralysis

1. Hemiplegia: one side of the body is affected
2. Diplegia: both sides of the body is affected (both legs or both arms)
3. Monoplegia: one limb is affected
4. Triplegia: three limbs are affected
5. Quadriplegia: all four limbs are affected