Nursing & Healthcare Programs

Applying Elastic Support Hose

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure for Applying an Elastic Support Hose

Equipment needed: elastic stockings.

  1. Perform hand hygiene.
  2. Explain the procedure to the patient and ask for his or her assistance in following directions.
  3. If the bed is adjustable, raise the bed to a comfortable working height.
  4. Assist the patient into a supine position.
  5. Expose the patient’s bare leg by removing any socks, shoes, or slippers.
  6. Turn the stocking inside out, down to the heel. To do this, slip the stocking onto your arm and grasp inside the heel pocket. With your other hand, turn the stocking inside out by pulling the stocking down your arm.
  7. Slip the foot into the stocking. Align the heel into the heel pocket and ensure the stocking is on straight. Smooth out any bumps before proceeding.
  8. Now, grab the inside-out portion of the stocking and begin pulling it over the foot, heel, and leg. The stocking will turn right side out as you pull it up the leg.
  9. Remove any wrinkles by smoothing out the stocking.
  10. Verify that the hose is on correctly and is not too tight or cutting off circulation.
  11. Repeat procedure on the other leg if necessary.
  12. Assist the patient back into a comfortable position.
  13. Perform hand hygiene.
  14. Document the procedure in the patient’s chart and report any changes in the patient’s condition to the nurse.

Important Information

Elastic stockings are worn to prevent deep vein thrombosis (DVT) and reduce the pooling of blood in vessels [1]. Many hospitals and care facilities use elastic stockings in patients with reduced mobility, such as surgical patients and/or the elderly. There are a few risks in wearing elastic stockings; however, these risks can be prevented with proper application and care.

First off, stockings should be the right size and shape for the person. Stockings that are too loose provide no benefit, whereas stockings that are too tight can cut off blood circulation, causing ischemia and increasing the risk for developing a DVT [1]. Second, stockings must be completely smooth, without folds or wrinkles. Folds and wrinkles may create a compressive band that can impede blood flow and result in patient injury [1].

Last, it is important to closely monitor patients wearing elastic stockings. Stocking should be worn for no longer than eight hours at a time, unless ordered otherwise. The stockings should be completely removed, and a nurse should assess the patient’s circulation. Nursing assistants should promptly notify the nurse if a patient complains of any numbness or tingling in the extremities.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356208/

More Resources

Measuring the Radial Pulse

The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.

Moving the Resident from a Bed to a Stretcher or Gurney

Moving a patient from a bed to a stretcher can pose huge safety risks to both the patient and to the health care workers completing the transfer. Always use the appropriate amount of people to complete a transfer, which may vary according to the patient’s weight and/or the facility’s policy. In some cases, a mechanical lift may be needed.

Fowler’s Position

Fowler’s position is used when a patient is eating, is having difficulty breathing, or is ordered by a doctor. This position is easily recognized because the patient will be sitting “straight up.” Semi-Fowler’s is sitting “half-way up,” and is used when patients cannot be laid flat, but wish to be in a more relaxed position than Fowler’s.

Supine Position

Supine position is a natural and comfortable position for most people. For this reason, it is a highly utilized position for nursing procedures. Unfortunately, this position puts pressure on many bony prominences that can lead to discomfort and/or pressure ulcers if the pressure is not relieved every so often (typically every two hours or less).

Offering the Bedpan

When a resident is bed-bound, they must use a bedpan to urinate and defecate. This can be embarrassing for the resident, so it should be done with sensitivity to the resident’s privacy and dignity. There are two types of bedpans. A regular bedpan is the deeper and more rounded of the two. A fracture pan has a relatively flat upper end with a trough at the lower end. Fracture pans are used for residents who have difficulty, or restrictions against, moving their hips and/or backs.

Measuring the Apical Pulse

The apical pulse rate is the most accurate non-invasive measurement of heart rate because it is measured directly over the apex of the heart. Apical pulse is preferred in cases when the radial pulse is difficult to palpate, when the pulse is irregular, greater than 100 beats per minute, or less than 60 beats per minute when measured by other means (electronic, radial, etc.).