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Gait Belt and Patient Mobilization Procedures (8.25)

Gait Belt and Patient Mobilization Procedures (8.25) - Policies, Clinical, UWHC Clinical, Department Specific, Nursing Patient Care, Misc

8.25

NURSING PATIENT CARE POLICY & PROCEDURE





Effective Date:
August 21, 2015

Administrative Manual
Nursing Manual (Red)
Other _______________

Policy #: 8.25

Original
Revision

Page
1
of 4

Title:
Gait Belt and Patient Mobilization
Procedures

I. PURPOSE

To prevent patient falls and to ensure the safety of patients and health care providers
during patient transfers and while ambulating patients on inpatient units.

II. POLICY

Health care providers will use a gait belt when transferring or ambulating patients
who are assessed to be unsteady and require the assistance of one or more persons.
All inpatient hospital units will have an adequate number of gait belts stocked with
Central Service supplies as determined by the needs of their patient population.


III. EQUIPMENT

A. Gait Belt – unit charge; 2 sizes available:
1. Gait Belt – 54 inches (CS #4004035)
2. Gait Belt – 72 inches (CS #4004036)

IV. PROCEDURE

A. Preparation
1. Check the patient’s active orders and interdisciplinary plan of care to
determine transfer and ambulation restrictions and/or requirements.
2. Explain the procedure to the patient and emphasize that the purpose of
the gait belt is to promote the safety of the patient and healthcare
provider.
3. Advance patient slowly from a lying to a sitting position.
4. Remain in front of the patient until the patient’s balance is restored. This
will help to prevent the patient from falling.
5. Apply only one gait belt of the appropriate size while the patient is in a
sitting position. Be sure that the patient has clothing or a gown on. Do
not apply the gait belt over bare skin.
6. Placement of gait belt:
a. Position the gait belt around the patient’s waist.
b. The buckle of the gait belt should clasp in front of the patient
around the navel area. The gait belt should be threaded through the
teeth side and then through the other side of the buckle.

Page 2 of 4

c. Adjust the gait belt so only two fingers fit between the belt and the
patient. It should be snug enough to prevent it from slipping
upward around the chest/breast area.
d. Ensure that the gait belt is flat (no twists) against the patient’s
waist.
e. If there is an abdominal wound/incision, colostomy, gastrostomy
tube or any abdominal precautions, the gait belt should not be
applied around the waist. In these situations, the gait belt can be
applied securely around the chest (above the breast in female
patients).
f. Patients should wear non-slip socks or shoes to prevent slipping or
falling.
B. Transfer of Patient from Bed to Wheelchair/Chair Using a Gait Belt
1. Adjust level of bed to best facilitate patient’s height and condition.
Consider using the lowest position for patients who are most unsteady or
very small in stature.
2. Position the wheelchair/chair at approximately a 45 to 90 degree angle.
Lock the brakes and either move the footrests to the side of the
wheelchair or remove the footrest from the wheelchair.
3. The gait belt should be snug and secure around patient’s waist and non-
skid socks or shoes should be worn by the patient to decrease the risk of
slipping or falling during the transfer.
4. Explain the transfer procedure to the patient, making sure the patient
understands the procedure and what is expected from both the patient
and the health care provider.
5. Position the patient’s feet flat on the floor.
6. Stand closely in front of the patient. Keep your feet apart with one foot
slightly ahead of the other to improve your balance. Bend knees and
keep back straight. Use your knees if necessary to provide additional
support and strength by placing your knees against the patient’s knees.
7. Place your hands under each side of the gait belt with an underhand
grasp.
8. Inform the patient that their assistance will be needed to stand on the
count of three (1, 2, 3). This ensures the patient and health care provider
will work together during the transfer.
9. Assist the patient up to a standing position on the count of three while
straightening the hips and legs and keeping knees slightly flexed.
10. Continue to maintain stability of patient’s weak leg with your knee if
necessary.
11. Pivot on foot farther from chair. Instruct the patient to back up until the
back of his knees/legs touch the wheelchair/chair, and to reach back with
his hands until he can touch the arm rests.
12. Bending at your hips and knees, slowly lower the patient into the
wheelchair/chair.
13. Loosen and/or remove the gait belt when the patient is secured in the
wheelchair.
14. Reposition or replace footrests and secure in the locked position.
15. Have patient place feet on the footrests of the wheelchair or assist if
necessary.

Page 3 of 4

16. Apply wheelchair seatbelt as indicated.
17. This procedure can be used to transfer the patient back to bed.
C. Patient Ambulation With a Gait Belt
1. Adjust level of bed to best facilitate patient’s height and condition.
Consider using the lowest position for patients who are most unsteady or
very small in stature.
2. Have patient dangle at bedside. Assess for dizziness, lightheadedness,
etc.
3. The patient should wear non-skid footwear to assure safety.
4. Explain the purpose of the gait belt during ambulation and how it will be
used. Make sure the patient has an understanding of the gait belt’s
purpose and what is expected.
5. Position the patient’s feet flat on the floor. Make sure the gait belt is
snug around the patient’s waist, allowing two fingers between the gait
belt and the patient. Grasp the belt with an underhand grip.
6. With the patient in a sitting position, ask the patient to push down on the
bed with his hands and lift his body up. Use the belt to assist the patient
with balance as needed. Do not use it to pull the patient into a standing
position. If the patient is using a walker, place the walker in front of the
patient prior to standing. If the patient is using crutches or a cane, give
them to the patient after standing.
7. Stand closely in front of the patient. Keep your feet apart with one foot
slightly ahead of the other to improve your balance. Bend knees and
keep back straight. Use knees if necessary to provide additional support
and strength by placing your knees against the patient’s knees.
8. Place your hands under each side of the gait belt with an underhand
grasp.
9. Inform the patient that their assistance will be needed to stand on the
count of three (1, 2, 3). Assist the patient to a standing position.
10. When the patient is steady, position yourself behind and slightly to one
side of the patient. Hold the gait belt firmly with an underhand grasp in
the center of the back. Place your second hand on the side of the belt.
11. Monitor the patient for tolerance, endurance and balance.
12. If the patient has low endurance, fatigues easily, or appears unsafe, a
second person should follow with a wheelchair so that the patient can sit
if necessary.
D. Gait Belt Care and Disposition
1. Gait belts are for single patient use only. Gait belts should remain with
patients throughout their hospitalization or until they are no longer
needed and are discarded. Gait belts may be given to patients on
discharge.
2. Gait belts can be washed in hot water and detergent in unit-based
washers and dryers or discarded when visibly soiled. Gait belts must not
be reused on another patient.
E. Documentation of Gait Belt Use
1. Document the use of gait belt the patient’s clinical record.




Page 4 of 4

V. REFERENCES

A. Arizona Direct Care Curriculum Project (2011). Principles of Caregiving:
Fundamentals. http://www.azdirectcare.org/uploads/2011_All_Fund_POC.pdf
B. How to Use a Gait Belt. http://www.drugs.com/cg/how-to-use-a-gait-belt.html
C. OSHA. Health Care Facilities Training. www.osha.gov/
D. Smith-Temple, J., Johnson, J.Y. (2009). Nurses' Guide to Clinical Procedures.
http://ovidsp.ovid.com.ezproxy.library.wisc.edu/ovidweb.cgi?T=JS&NEWS=n&
CSC=Y&PAGE=booktext&D=books&SC=01435374
E. Use of Transfer/Gait Belt: General Guidelines.
http://academic.cuesta.edu/fjohnson/PowerPoint_PDF/gaitbelts.pdf
F. Mobility Decision Support tool. Adapted from Interior Health Administrative
Policy manual http://www.interiorhealth.ca January, 2014. Prepared by Mobility
Steering Committee August 2014. Updated April, 2015.

VI. REVIEWED BY

Clinical Nurse Specialist, Rehabilitation
Clinical Nurse Specialist, Nursing Quality and Safety
Manager, Inpatient Physical Therapy
Manager, Inpatient Rehabilitation Unit Therapy team
Supervisor, Physical Therapy
Nursing Patient Care Policy and Procedure Committee, August 2015.

SIGNED BY

Beth Houlahan, DNP, RN, CENP
Senior Vice President Patient Care Services, Chief Nursing Officer