Mobility - Assistive devices: Nursing skills

Assistive devices for ambulation, or just ambulation devices, are tools used to aid in walking. The most common types include walkers, canes, and crutches. As the nurse, you need to know when each of these are appropriate and assess if the client is using them correctly. Remember that a client’s ambulation device is specially ordered and fits them specifically, kind of like glasses, so they should not be shared with other clients. Some devices like mechanical lift, are used by clients who aren’t able to ambulate independently and need assistance to move from one location to another. Nurses often use mechanical lifts to make sure the client is safe during transfer. Let’s start by looking at walkers. These are movable, lightweight devices that consist of a metal frame, 2 hand grips, and 4 legs. Walkers provide great stability due to their wide base, so they are great for people who can bear weight on their feet but have trouble walking due to weakness of the legs or balance issues. When assessing the proper fit of a client’s walker, make sure that the hand grips are at the client’s waist level. Check the legs because they should have non-slip tips like a rubber cover.

To use a walker, the client should stand straight while holding the hand grips. When moving forward, they lift it up and move it another 6-10 inches in front of them and set it down. Because many clients have difficulty lifting a walker, many models now have wheels on the front legs. However, these are prone to rolling forward, so brakes are usually built in. So, when the client is going to stand for a while, make sure the brakes are locked. Using the walker as support, they should move one leg forward and then the other. Once balance is reestablished, repeat the process. Next up, we have canes. These are also movable, lightweight devices made of a strong material like wood or metal. Canes consist of a handle, a shaft, and legs. There are single leg, triple leg or quad leg canes, and the ones with multiple legs provide more stability but are also more cumbersome. Canes are used by clients who could bear weight but have weakness in one of their legs, like a client who had a stroke or those with paralysis in one leg.

Crutches and walkers are better for people with two weak legs. A properly fitted cane should have the handle at the client’s hip level. The tips should also be non-slip. When using a cane, hold it on the strong side, or the side without weakness. The cane tip should rest flat on the ground at the start and then lifted and moved forward 6-10 inches before being placed flatly on the ground again. Step forward with the weaker leg first, using the cane for support. After balance is established, move the stronger leg forward. The most vulnerable point is when only the weak leg and the cane are on the ground. Crutches are the last kind of common ambulation device. They are either single or paired and are used by people who cannot bear weight on one or both legs. There are two common types of crutches: underarm, or axillary, and forearm crutches. Axillary crutches stretch from the armpits, or axilla, to the ground. They provide better balance but require more upper body strength to use. They are often used temporarily, like when someone is recovering from leg injuries.