Policy Manual sample

MDT Home Health Care Agency, Inc. 36 ELASTIC STOCKING APPLICATION PURPOSE: Application of elastic stockings is done in accordance with the physician’s plan of care to provide circulatory support and reduce swelling of extremities. An assessment of the lower extremities for swelling, color changes, temperature changes, presence of pain, areas of constriction or skin abrasion should always accompany the changing of elastic stockings. RESPONSIBLE PERSONNEL: RN, LPN, HHA SPECIAL CONSIDERATIONS: 1. Measurement for proper fit varies from one manufacturer to another, and from one stocking style to another. Stockings normally come in small, medium, large and x- large. The size of a patient’s calf, and in some cases, the distance between the heel and the popliteal space influences the size needed. 2. Having 2 pairs of stockings permits laundering without interruption of use. 3. Follow manufacturer’s directions before laundering. 4. Stockings should be put on patient in the morning, if possible, because they are easier to apply if there is no dependent edema. PROCEDURE: 1. Wash hands. 2. Explain purpose of elastic stockings. 3. Identify the correct stocking for each leg. 4. The patient’s foot should be supported at the heel. 5. Turn stocking inside out while holding onto foot position and check for correct toe and heel placement. 6. Continue pulling the stocking up the leg, smoothing as you go. Do not allow the top to roll down. Ensure top of stocking is not restrictive behind the knee. 7. Do not use powder to ease application. 8. To remove the stockings, grip the top of the stocking with both hands and gently pull downward. 9. Wash the stockings in accordance with manufacturer’s directions. 10. Wash hands. DOCUMENTATION: Document in patient’s clinical record the application of the stockings. Note any changes in condition of lower extremities and physician notification as indicated. Document any teaching performed and the patient’s or caregiver’s response.