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

Making an Occupied Bed

If a patient is bedridden or on bedrest, the bed linens will need to be changed while the patient is in the bed. For safety reasons, the nurse’s aid should avoid making an occupied bed if the patient is able to get out of bed. Bed linens should be changed according to the facility’s policy or anytime they are wet or soiled.

Nail Care (Fingers and Toes) for CNAs

Nail care of both the feet and the hands should be performed as part of the patient’s daily hygiene routine. The status of the patient’s nails can reflect their overall health. Nail issues can also lead to infection that can spread systemically (ex, ingrown nails or fungus). You should never clip a patient’s nails with nail clippers, and always review your institution’s policy about what nail care is allowed.

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).

Putting on Personal Protective Equipment

Personal protective equipment is worn to protect the mouth, nose, eyes, clothing, and skin from unwanted pathogens. In the health care setting, a patient’s condition often prompts the use of personal protective equipment; however, a health care worker is able to wear personal protective equipment whenever he or she deems it is necessary (e.g., during procedures with the potential for excessive contact with bodily fluids).

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.