Assisting a Patient With Ambulation Using a Walker

Goal: The patient ambulates safely with the walker and is free from falls or injury.

1. Review the medical record and nursing plan of care for conditions that may influence the patient’s ability to move and ambulate, and for specific instructions for ambulation such as distance. Assess for tubes, IV lines, incisions, or equipment that may alter the procedure for ambulation. Assess the patient’s knowledge and previous experience regarding the use of a walker. Identify any movement limitations.

2. Perform hand hygiene. Put on PPE, if indicated.

3. Identify the patient. Explain the procedure to the patient. Tell the patient to report any feelings of dizziness, weakness, or shortness of breath while walking. Decide how far to walk.

4. Place the bed in the lowest position, if the patient is in bed.

5. Encourage the patient to make use of a stand-assist aid, either free-standing or attached to the side of the bed, if available, to move to the side of the bed.

6. Assist the patient to the side of the bed, if necessary. Have the patient sit on the side of the bed. Assess for dizziness or lightheadedness. Have the patient stay seated until he or she feels secure.

7. Assist the patient to put on footwear and a robe, if desired.

8. Wrap the gait belt around the patient’s waist, based on assessed need and facility policy.

9. Place the walker directly in front of the patient. Ask the patient to push him- or herself off the bed or chair; make use of the stand-assist device, or assist the patient to stand. Once the patient is standing, have him or her hold the walker’s hand grips firmly and equally. Stand slightly behind the patient, on one side.

10. Have the patient move the walker forward 6 to 8 inches and set it down, making sure all four feet of the walker stay on the floor. Then, tell the patient to step forward with either foot into the walker, supporting him- or herself on his or her arms. Follow through with the other leg.

11. Move the walker forward again, and continue the same pattern. Continue with ambulation for the planned distance and time. Return the patient to the bed or chair
based on the patient’s tolerance and condition, ensuring that the patient is comfortable. Make sure call bell and other necessary items are within easy reach.

12. Remove gait belts. Clean transfer aids per facility policy, if not indicated for single patient use. Remove gloves and any other PPE, if used. Perform hand hygiene.