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TRINITY VALLEY COMMUNITY COLLEGE ASSOCIATE DEGREE NURSING RNSG 1216

PROCEDURE GUIDE AND CHECK-OFF SHEET USING A WALKER

Walkers may be on a temporary or permanent basis for patients with orthopedic or neurological injuries. Upper body strength and balance need to be assessed.

Delegation: This procedure may be delegated to unlicensed assistive personnel. Evaluations and instructions must be completed by a nurse.

Procedure Scientific Rationale 1.The following equipment is needed for this skill: a. walker with rubber tips. a. Standard: Prevents walker from slipping. (standard walker – picked up and moved) Roller: For patients with weak arm strength. (roller walker – 2 to 4 wheels) b. supportive shoes with non-skid soles b. Prevents feet from slipping. c. gait belt. c. Safely help patient to stand. 2. Inspect condition of walker: rubber tips in place, Ensures safety. without cracks. 3. Assess patient’s upper body strength, ROM in arms. Toned arm muscles and upper body strength is required to use a walker. 4. Teach patient importance of exercising arms. Arms are used to support weight of body. 5. Measure/adjust walker to fit patient based on Ensures safety. height. Place walker in front and partially around patient. Patient’s elbows are slightly flexed with hand grip slightly below patient’s waist or at wrist level when arm is hanging by side. 6. Help patient to standing position by using a gait Gives support during transferring patient to another belt. Note: Refer to transfer from bed to chair position. procedure. 7. Walking Using a Walker Instruct patient to: a. Stand with walker in front and partly around patient. b. Move walker only one step length ahead, b. Stepping too far into walker could cause loss of placing all 4 legs of walker on the floor. balance. c. Then move the weaker leg forward. c. Weaker leg is moved first so that body weight is d. Push down on walker, and advance good leg divided between walker and good leg. alongside or even with sore leg. e. Continue until destination is reached – walker, sore leg, good leg; walker, sore leg, good leg. 8. Sitting/Standing Using Walker Instruct patient to: a. To sit – with back of good leg against chair, a. Ensures balance. move sore leg forward, place hands on chair arms and lower self onto chair. b. To stand – Place walker in front of patient, b. Ensures balance. move forward in chair, push self up using

175 Procedure Scientific Rationale chair arms, move sore leg forward with good leg next to chair and put both hands on hand grips of walker. c. Do not lean on walker when sitting down or c. Walker could tip over. standing up. 9. Document mobility and patient’s tolerance of All data must be entered in patient’s record. procedure.

N:ADN/ADN Syllabus/CBC Curriculum/Level I/1216/Performance Checklist for Basic Skills - Using a Walker Reviewed 04/16