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Using a Gait / Transfer Belt to Assist the Resident to Ambulate

Written by Amanda R. McDaniel, MS, BSN, RN
Amanda is a BSN/RN with a MS in Physiology and a BA in English. She worked as a medical writer in the pharmaceutical industry for 11 years before pursuing a career in nursing. She now works as a nurse on a NeuroTelemetry unit and continues to write and edit on a freelance basis. Amanda’s LinkedIn

Walking (aka, ambulating) helps residents maintain mobility and independence, and prevents complications. However, ambulation must be done safely so that the resident does not have a fall or injury. A gait or transfer belt, when properly used, can increase resident safety. Gait belts can vary between facilities, so make sure you know how to use the one in your facility.

Ambulating with a Gait/Transfer Belt

  1. Prepare for ambulation and gather your supplies.
    • Position chairs in the hallway at safe rest points in case the resident tires and needs a break during ambulation.
    • Help the resident put on non-skid shoes, slippers, or socks.
    • Have an appropriately-sized gait belt. Most gait belts fit residents with waist sizes up to 51 inches. Bariatric belts can accommodate waist sizes up to 71 inches. If in doubt, measure or ask a nurse or physical therapist what size to use.
  2. Apply the gait belt.
    • Help the resident to a sitting position.
    • Wrap the belt around the resident’s waist. The belt should always be applied over clothing.
    • The metal tip of the belt goes into the buckle through the side with teeth first. Pull the belt through, pass the tip over the buckle, then through the smooth side.
    • Pull the belt snug around the resident’s waist. Make sure that female resident’s breasts are not caught under the belt.
    • You should be able to slide one open, flat hand under the belt.
    • The buckle should be off-center and any excess belt strap should be tucked into the belt.
  3. Assist the resident to standing.
    • Stand in front of the resident with your feet in a stable position and your knees in line with the resident’s. Slightly bend your hips and knees.
    • If the resident has a leg that is weaker, the strong leg should be forward.
    • Grasp the belt at the resident’s sides.
    • On the count of three, rock the resident up to a standing position. Be sure to keep your knees bent. The resident should be doing most of the work. You are just helping guide them.
  4. Once the resident is standing, ask if they are having any dizziness. Watch them for swaying or any other indicators that they are having trouble standing. If they are, immediately assist them back to the sitting position.
  5. Once you have verified that the resident is steady, turn so that you are to one side and slightly behind the resident.
    • If the resident has a weak side, that is the side you should stand on.
  6. Hold on to the gait belt with one hand behind the resident and one at the resident’s side.
  7. Have the resident begin walking. Remind them to place their feet heel first, then toe. Their back should be straight and their head should be up, looking forward.
  8. Walk the ordered distance with the resident. If the resident tires, have them rest in one of the chairs you placed in the hallway.
  9. When the walk is over, return the resident to their bed or chair and remove the gait belt.
  10. Document the ambulation per institutional or unit policy. Report any difficulty during ambulation to the nurse per policy.

References

Activity and mobility. (2014). In A. G. Perry, P. A. Potter, and W. R. Ostendorf (Eds), Clinical nursing skills & techniques (8th ed., pp. 203-204). St. Louis, MO: Mosby Elsevier.

S. A. Sorrentino, & L. N. Remmert. (2012). Mosby’s textbook for nursing assistants (8th ed., pp 190-192, 502). St. Louis, MO: Elsevier Mosby.

More Resources

Dressing and Undressing a Patient

Patients who have suffered a stroke or have weakness or injury to one side of their body may struggle with dressing and undressing. In order to help these patients regain their strength and independence, it is important that the nurse’s aide only assist them as needed. The nurse’s aide may need to teach patients how to dress and undress safely with their limitations.

Applying Elastic Support Hose

Elastic stockings are worn to prevent deep vein thrombosis (DVT) and reduce the pooling of blood in vessels. 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.

Feeding the Patient

Not all patients will need help feeding themselves. Some patients will only need assistance opening cartons or cutting their food. To promote independence, always let the patient do as much as he or she can before assisting. It is vitally important that the nurse’s aide verifies that the patient receives the correct meal tray. Patients may have special diets that play a critical role in their health (i.e., pureed diet, gluten-free diet, food allergies, etc.). Feeding the wrong food to the wrong patient could result in serious complications.

Transferring the Resident from a Bed with a Mechanical Lift

A mechanical lift is used to transfer residents who cannot support their own weight. When used properly, mechanical lifts prevent injuries for both residents and health care workers. It is important that a nurse’s assistant be trained to use the mechanical lift before attempting to operate it. Most facilities require at least two health care workers to assist when using a mechanical lift.

Partial Bed Bath

Bathing is an important part of a patient’s health routine. A partial bed bath focuses on bathing sensitive areas that cause discomfort if not cleansed frequently, such as the face, hands, axillae, back, and perineum. Though patients receiving a bed bath are typically confined to the bed, some are able to wash themselves and should be encouraged to do so to promote independence.

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).

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