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Ambulation From Wheelchair

2 min read

Ambulation From Wheelchair

Key Points

  • Safe ambulation starts with locked wheelchair brakes, gait-belt setup, and nonskid footwear.
  • Assistant position is on the resident’s weak side and slightly behind while supporting gait belt.
  • If dizziness appears before first steps, reseat and reassess before retrying.
  • Controlled return to seated position requires brake verification and cueing when knees contact chair.

Equipment

  • Gait belt
  • Wheelchair
  • Nonskid footwear
  • Ordered assistive device (walker or cane) if indicated
  • Hand hygiene supplies

Procedure Steps

  1. Perform routine pre-procedure actions: knock, identify resident, explain procedure, provide privacy, and perform hand hygiene.
  2. Verify wheelchair brakes are locked before standing attempt.
  3. Confirm resident has nonskid footwear.
  4. Apply gait belt and confirm snug fit (fingers can slide under belt).
  5. Ask about dizziness/light-headedness before standing.
  6. Stand facing resident with stable stance and feet positioned for slip prevention.
  7. Cue resident to push up from wheelchair arms and stand on count of three.
  8. Assist to standing and provide ordered assistive device.
  9. Move to resident’s weak side, slightly behind, and support gait belt with palms/fingertips up.
  10. Stabilize and guard while resident ambulates; cue upright posture, forward gaze, and purposeful steps.
  11. Reassess symptoms during ambulation and stop early if resident reports dizziness, weakness, or fatigue beyond tolerance.
  12. Use wheelchair follow support when weakness/dizziness risk is present; lock brakes before any seated rest (or stabilize wheelchair from behind in emergent sit-down).
  13. Pivot resident back in front of wheelchair, recheck brakes locked, and cue armrest reach when knees touch seat.
  14. Assist controlled sit, remove gait belt, release brakes when safe, then complete post-procedure comfort/safety checks.
  15. Document ambulation distance and resident tolerance response.

Common Errors

  • Beginning ambulation with unlocked brakes → unstable start and fall risk.
  • Standing on strong side when weakness is unilateral → reduced protective support.
  • No dizziness check before stand → orthostatic fall risk.
  • Sitting resident before knees align with chair → missed seat and injury risk.

Graph View