COLLEGE OF NURSING

Page 1/2
Remarks:

Instruction: check on the column of your choice as to what level is the performance of the student in the following procedure. Be
guided in the scoring with the legend below:
Legend: Level of performance
4 Very satisfactory (Performed all the procedures correctly)
3 Satisfactory (Needs minimal assistance in performing the procedure)
2 Good (Needs more practice in performing the procedure)
1 Fair (inappropriate in the performance of the procedure)
Name / Signature of Student Name / Signature of RD Instructor
STEP PROCEDURE 4 3 2 1
1 Review the medical record and nursing plan of care for conditions that may influence the patient’s
ability to move and ambulate, and for specific instructions for ambulation such as distance.
 Assess for tubes, IV lines, incisions, or equipment that may alter the procedure for
ambulation.
 Assess the patient’s knowledge and previous experience regarding the use of a walker
 Identify any movement limitations
2 Identify the patient and explain the procedure.
 Tell the patient to report any feeling of dizziness, weakness, or shortness of breath while
walking. Decide how far to walk
3 Perform hand hygiene
4 Place the bed in the lowest position
5 Encourage the patient to make a use of a stand-assist aid, either free standing or attached to the side
of the bed, if available, to move to the side of the bed.
6 Assist the patient to the side of the bed, if necessary. Have the patient sit on the side of the bed.
Assess for dizziness or lightheadedness. Have the patient stay sitting until he or she feels secure.
7 Assist the patient to put on footwear and a robe, if desired
8 Wrap the gait belt around the patient’s waist based on assessed need and facility policy.
9 Place the walker directly in front of the patient
 Ask the patient to push himself or herself off the bed or chair, make use of the stand-assist
device or assist the patient to stand.
 Once the patient is standing, have him or her hold the walker’s hand grips firmly and
equally. Subtotal:
 Stand slightly behind the patient, on one side. Total Score:
10 Have the patient move the walker forward 6” to 8” and set it down, making sure all fourPerfect feet ofScore:
the 48
walker stay on the floor.
 Tell the patient to step forward with either foot into the walker, supporting himself or herself
on his or her arms. Follow through with the other leg.
 If one leg is weaker or impaired, have the patient step forward with the involved leg and
follow with the uninvolved leg, again supporting himself or herself on his or her arms.
11 Move the walker forward again, and continue the same pattern. Continue with ambulation for the
planned distance and time.
 Return the patient to the bed or chair based on the patient’s tolerance and condition,
ensuring that the patient is comfortable and call light is within reach.
12 Remove gait belt. Perform hand hygiene.

ASSISTING A PATIENT WITH AMBULATION USING A WALKER

UC-VPAA-CON-FORM-99 Page 1 of 2
JUNE 2012 REV: 00
UC-VPAA-CON-FORM-99 Page 2 of 2
JUNE 2012 REV: 00