Chapter 13 Assisting with Mobility 383 Copyright Goodheart-Willcox Co., Inc. 12. Using the gait belt, assist the patient to a standing position. Lift her using your arm and leg muscles. Bend your knees and keep your back straight. Do not twist your body. 13. Continue to hold on to the gait belt while the patient gains her balance. Have her stand erect with her head up and back straight. 14. The cane should be positioned and the patient stabilized with the cane before ambulation begins. 15. When ambulation begins, the cane should be moved forward about 6 to 10 inches (Figure 13.13). 18. Grasp the gait belt with an underhand grip from the back, if needed. 19. Encourage the patient to use handrails, if available. 20. Let the patient set the pace while keeping a fi rm grasp on the gait belt, if used. Encourage the patient to achieve the ordered distance, but be observant. Watch for signs of patient fatigue or possible collapse. Do not attempt to catch a patient who begins to collapse during ambulation. Instead, slowly ease the patient to the fl oor, using your body as an incline. 21. If permissible, and the patient is strong enough, she may be assisted with climbing stairs with a cane. Before beginning, check to be sure that she is able to safely walk on fl at surfaces. 22. Have the patient grasp the handrail (if possible) with the hand on her weak side. Ask her to hold the cane in her opposite, strong hand. 23. The patient should step up the stair using her strong leg fi rst. Once balanced, the cane should then be moved up the stair, followed by the weak leg. This is repeated to move up the stairs. 24. To come down stairs, the cane should be placed on the step fi rst, followed by the weaker leg and then the stronger leg. Remember to have the patient face forward and “go up with the good, down with the bad.” When going up, lead with the strongest leg. When going down, lead with the weaker one. 25. When the ambulation is completed, help the patient return to her room (or bed). Remove and put away the gait belt, robe, cane, and shoes. Follow-up 26. Make sure the patient is safe and comfortable. Place the call light and personal items within easy reach. 27. Wash your hands to ensure infection control. Reporting and Documentation 28. Communicate any specifi c observations, complications, or unusual responses to the appropriate provider. Also record this information in the patient’s chart or EMR. Procedure 13.2 Assisting with Ambulation Using a Cane (continued) Wards Forest Media, LLC Figure 13.13 16. The patient should follow, fi rst with the weak leg and then with the strong leg. 17. If using a gait belt, stand slightly behind the patient on her weaker side to provide additional support as needed.