Nursing & Healthcare Programs

Applying Elastic Support Hose

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure for Applying an Elastic Support Hose

Equipment needed: elastic stockings.

  1. Perform hand hygiene.
  2. Explain the procedure to the patient and ask for his or her assistance in following directions.
  3. If the bed is adjustable, raise the bed to a comfortable working height.
  4. Assist the patient into a supine position.
  5. Expose the patient’s bare leg by removing any socks, shoes, or slippers.
  6. Turn the stocking inside out, down to the heel. To do this, slip the stocking onto your arm and grasp inside the heel pocket. With your other hand, turn the stocking inside out by pulling the stocking down your arm.
  7. Slip the foot into the stocking. Align the heel into the heel pocket and ensure the stocking is on straight. Smooth out any bumps before proceeding.
  8. Now, grab the inside-out portion of the stocking and begin pulling it over the foot, heel, and leg. The stocking will turn right side out as you pull it up the leg.
  9. Remove any wrinkles by smoothing out the stocking.
  10. Verify that the hose is on correctly and is not too tight or cutting off circulation.
  11. Repeat procedure on the other leg if necessary.
  12. Assist the patient back into a comfortable position.
  13. Perform hand hygiene.
  14. Document the procedure in the patient’s chart and report any changes in the patient’s condition to the nurse.

Important Information

Elastic stockings are worn to prevent deep vein thrombosis (DVT) and reduce the pooling of blood in vessels [1]. Many hospitals and care facilities use elastic stockings in patients with reduced mobility, such as surgical patients and/or the elderly. There are a few risks in wearing elastic stockings; however, these risks can be prevented with proper application and care.

First off, stockings should be the right size and shape for the person. Stockings that are too loose provide no benefit, whereas stockings that are too tight can cut off blood circulation, causing ischemia and increasing the risk for developing a DVT [1]. Second, stockings must be completely smooth, without folds or wrinkles. Folds and wrinkles may create a compressive band that can impede blood flow and result in patient injury [1].

Last, it is important to closely monitor patients wearing elastic stockings. Stocking should be worn for no longer than eight hours at a time, unless ordered otherwise. The stockings should be completely removed, and a nurse should assess the patient’s circulation. Nursing assistants should promptly notify the nurse if a patient complains of any numbness or tingling in the extremities.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1356208/

More Resources

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Perineal care should be performed during a bath, after using the bedpan, and/or after incontinence. Special care should be used when performing perineal care on an uncircumcised male. Failure to retract and wash the area under the foreskin can result in infection. Failure to return the foreskin to its normal position can result in paraphimosis.

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Applying Restraints

Restraints have very strict guidelines for use due to the number of complications that can result. Use of restraints is associated with increased physical and psychosocial health issues. Restraints are only considered necessary when restraint-free alternatives have failed and the patient or others are at risk of harm without the restraints. It is illegal to use restraints for the staff’s convenience or to punish the patient.

Using a Gait / Transfer Belt to Assist the Resident to Ambulate

Walking (aka, ambulating) helps residents maintain mobility and independence, and prevents complications. However, ambulation must be done safely so that the resident does not have a fall or injury. A gait or transfer belt, when properly used, can increase resident safety. Gait belts can vary between facilities, so make sure you know how to use the one in your facility.

Measuring Blood Pressure

Many factors can interfere with obtaining an accurate blood pressure. The most common mistakes that lead to inaccurate blood pressures are a result of improper technique, including: not supporting the patient’s arm, using the wrong sized cuff, positioning the cuff too low on the patient’s arm, improper positioning of the cuff’s artery marker, and attempting to measure blood pressure through clothing.

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

Moving the Resident from a Bed to a Stretcher or Gurney

Moving a patient from a bed to a stretcher can pose huge safety risks to both the patient and to the health care workers completing the transfer. Always use the appropriate amount of people to complete a transfer, which may vary according to the patient’s weight and/or the facility’s policy. In some cases, a mechanical lift may be needed.