Policy Manual sample

MDT Home Health Care Agency, Inc. 1 AMBULATION PURPOSE: Patients will be encouraged to ambulate as able in the home to increase mobility and independence and to stimulate circulation and reduce fatigue. Ambulation activity will be identified on an individual assessment and/or physician's order as necessary, based on diagnosis and assessment data. RESPONSIBLE PERSONNEL: All Staff EQUIPMENT: Specified equipment as indicated by individual assessment/assignment (HHAs) and in accordance with physician’s orders (gait belt, cane walker) as needed. SPECIAL CONSIDERATIONS: Initially, goals should be short range and obtainable to increase patient's sense of well being and to prevent discouragement and fatigue. The patient should be encouraged to assume a normal position of body alignment. It is important to coordinate balance, endurance, length of steps, width of stance, and to consider if more than one caregiver is needed to assist. The patient should be encouraged not to reach for environmental supports, but to continually ambulate from object to object (i.e., from chair to sofa to table, etc.). Patient cooperation with a schedule of ambulation is better achieved if habits prior to illness are considered. Patient and caregiver should be encouraged to consider possible safety risks in the home and consider ways to eliminate or minimize these. Patients should wear laced shoes with non-slip/non-skid soles. PROCEDURE: With assistive canes or quad cane: 1. Explain procedure to patient. 2. Bring appropriate cane or walker to patient, if indicated. 3. Have patient stand in normal position. Assess for sense of balance. 4. Hold cane in hand opposite affected extremity. Position cane 4-6 inches away from uninvolved extremity. 5. The elbow should be slightly flexed. Move cane forward about the length of the foot. Follow by moving the involved leg forward. Keep toes parallel to cane. 6. Keep good leg with heel parallel to cane. 7. Have patient move uninvolved leg and cane simultaneously ahead of involved leg. 8. Continue with program until goals are met. 9. Give verbal encouragement. With one assistant: 1. Assist patient to standing position. Have patient stand still to gain balance. 2. Place folded sheet or gait belt around the patient's waist. 3. Firmly grip belt or towel at back (midline). Stand slightly behind affected side. 4. Place your other hand on patient's shoulder.