Goal: The stockings are applied and removed with minimal discomfort to the patient.
1. Review the medical record and medical orders to determine the need for antiembolism stockings.
2. Perform hand hygiene. Put on PPE, as indicated.
3. Identify the patient. Explain what you are going to do and the rationale for use of elastic stockings.
4. Close curtains around bed and close the door to the room, if possible.
5. Adjust the bed to a comfortable working height, usually elbow height of the caregiver (VISN 8 Patient Safety Center, 2009).
6. Assist patient to supine position. If patient has been sitting or walking, have him or her lie down with legs and feet well elevated for at least 15 minutes before applying stockings.
7. Expose legs one at a time. Wash and dry legs, if necessary. Powder the leg lightly unless patient has a breathing problem, dry skin, or sensitivity to the powder. If the skin is dry, a lotion may be used. Powders and lotions are not recommended by some manufacturers; check the package material for manufacturer specifications.
8. Stand at the foot of the bed. Place hand inside stocking and grasp heel area securely. Turn stocking inside-out to the heel area, leaving the foot inside the stocking leg.
9. With the heel pocket down, ease the stocking foot over the foot and heel. Check that patient’s heel is centered in heel pocket of stocking.
10. Using your fingers and thumbs, carefully grasp edge of stocking and pull it up smoothly over ankle and calf, toward the knee. Make sure it is distributed evenly.
11. Pull forward slightly on toe section. If the stocking has a toe window, make sure it is properly positioned. Adjust if necessary to ensure material is smooth.
12. If the stockings are knee-length, make sure each stocking top is 1 to 2 inches below the patella. Make sure the stocking does not roll down.
13. If applying thigh-length stocking, continue the application. Flex the patient’s leg. Stretch the stocking over the knee.
14. Pull the stocking over the thigh until the top is 1 to 3 inches below the gluteal fold. Adjust the stocking, as necessary, to distribute the fabric evenly. Make sure the stocking does not roll down.
15. Remove equipment and return patient to a position of comfort. Remove your gloves. Raise side rail and lower bed.
16. Remove any other PPE, if used. Perform hand hygiene. Removing Stockings
17. To remove stocking, grasp top of stocking with your thumb and fingers and smoothly pull stocking off inside out to heel. Support foot and ease stocking over it.
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