Application and Charting

Purpose Treatment or PreventionBasic treatment for chronic venous

disorders of the legsImprove circulation of legs and feetPrevent the formation of blood clots

Check Chart for OrdersClient’s legs must be measured for individual

fitDoctor order:

Length (knee high or thigh high)Strength of compression varies

Facility policy on who can apply hose VariesFollow the policy of your facililtyFollowing Charting Rules following application

Application of HoseClient should be sitting with legs up or lying

down while stockings are offReapply before client stands or sits on side of

bedImproper application can block circulation

and cause tissue damageRemove 2 to 3 times a day (every 8 hours)

Care of StockingsWash regularlyHand wash and air dry

Potential ProblemsIdeally Clients can apply hose themselvesElderly, weak, or arthritic cannot apply

themselvesPoor patient compliance (choose not to wear)Intolerance of sensation of compression

(discomfort)Stockings vary with strength of compression

High compression makes more difficult to put on

Aids to ApplicationSilk inner sleeve covering for foot (use with

toeless stockings and remove post application)

Butler device (wire frame)Talc (powder)

Chart any Abnormalities• Check hose at intervals (Check every 8 hours)Signs of Circulation Abnormal skin color Temperature Swelling Other abnormalitiesChange hose if soiled

Report or Record (Chart)DateTimeApplied to Both, or left or right legUnusual appearance of skin SwellingSignature and title

Patient Teaching For improved blood circulation...Do Not sit or stand in one place for extended

periods of time.Do Not cross your legs while sitting. When sitting elevate your feet with a chair,

stool or pillow. Exercise will help tone muscles and improve

circulation. Always follow your physician's instructions.

Diseases treated with Elastic StockingsDiabetic Peripheral NeuropathySuperficial Thrombophlebitisvaricose_veins

Preventative treatment is Elastic Stockingshttp://www.wrongdiagnosis.com/d/deep_vein_

thrombosis/intro.htmhttp://www.wrongdiagnosis.com/p/pulmonary

_embolism/intro.htmhttp://www.wrongdiagnosis.com/s/superficial

_thrombophlebitis/intro.htmhttp://www.wrongdiagnosis.com/t/thrombosis

/intro.htm

Diseases treated with Elastic Stockingshttp://www.wrongdiagnosis.com/d/diabetic_p

eripheral_neuropathy/intro.htmhttp://www.wrongdiagnosis.com/s/superficial

_thrombophlebitis/intro.htmhttp://www.wrongdiagnosis.com/v/

varicose_veins/intro.htm

Preventative treatment is Elastic Stockingsdeep_vein_thrombosispulmonary_embolismsuperficial_thrombophlebitisthrombosis

Care of HoseChange Hose whenever they are soiledNOTE: STOCKINGS SHOULD BE WASHED

IN MILD SOAP AND HUNG TO DRYPER CLIENT'S OR SUPERVISOR’S

DIRECTION.

EndPower Point by Pat Rape

(pat.rape.email@gmail.com)Attachment:

Applying Elastic Stockings: Physical and Occupational Therapy Services c. Demonstrate techniques for applying anti-embolic hose to extremities.

Name ______________________ Start date_________________ Completion of performance date ____________ Each student must practice the procedure with peer checks before final check off performance. Possible points will be awarded for performing the task correctly; no points will be awarded if the student does not meet criteria for the task Task Possible

Points Peer Check

Final Check

Comments

Check doctor’s orders for type procedure and special orders

5

Examine the hose for size and cleanliness

5

Introduce yourself giving your title (RN, PT,PTA.)

5

Provide privacy (HIPAA) 5

Assess the client’s ability to understand or communicate

5

With the patient lying down, expose one leg at a time (check to see if clean & dry)

5

Grasp stocking at top with both hands and fold inside out toward toe end with raised seams on the outside

10

Adjust over the client’s toes with opening at base of toes; fit client’s heel into the heel portion

10

Apply stocking by folding upward toward the body

10

Check to be sure the stocking is applied evenly and smoothly, w/o wrinkles. Avoid pulling hair on the client’s legs

10

Repeat procedure on opposite leg

5

Check for safety and comfort, report anything unusual to supervisor

10

Wash your hands 5 Record what you have done 10

Total Points

100

Comments __________________________________________________________