12.5.2: Procedure- Assisting with the Use of Elastic Support Stockings
Some patients may be prescribed by their doctor special elastic support stockings or compression stockings to wear on their legs. These stockings are used for patients with poor circulation who are at risk for getting a blood clot. They are also used to help prevent or reduce swelling. Stockings should be placed on the patient’s legs prior to them getting out of bed in the morning. Follow manufacturer instructions in applying stockings. Follow instructions written in the Care Plan for guidelines for when to apply, how long the patient should wear stockings each day, and when to remove stockings.
- Explain the procedure to the patient. Ensure they understand the importance of wearing the elastic support stockings. Seek guidance from a supervisor as needed and report refusal to wear stockings.
- Wash and dry your hands.
- Assemble equipment (e.g. support stockings, lotion, shoes).
- If the patient has been moving around out of bed, have them lie down with their legs elevated for 15 minutes before applying the stockings.
- Make sure legs are clean and dry. Observe skin for condition and changes such as sores, swelling, and changes in color. Make note of any observed changes and any patient complaints such as numbness, pain, or tingling in the lower extremities.
- You may use powder or lotion on the patient’s legs prior to applying the stockings. This provides for comfort, ease of application of stockings, and protection for the patient’s skin.
- Raise the bed to waist height. Position patient in the supine (lying on back) position.
- Apply stockings according to the Care Plan and as a supervisor directs.
- Place your hand and arm inside one stocking and turn it inside out up to the heel of the stocking. Grasp the heel of the stocking with your fingers of the hand holding the stocking.
- Move the stocking down over your arm so that the length of the stocking is now bunched near your hand.
- Carefully take the patient’s foot and position the opening of the stocking that is near your hand over the patient’s toes.
- Place the foot of the stocking over patient’s toes, then over the foot, then over the heel. Pull the stocking up slowly as you move it upwards over the patient’s leg.
- Gently pull the top of the stocking up over the entire calf.
- Make sure the heel of the foot is in the heel of the stocking.
- If there are no toe openings, gently pull on the tip of the stocking by the toes to relieve pressure. For stockings with toe openings, the patient’s toes should be positioned appropriately in the toe area.
- Repeat with the other leg.
- Always ensure there are no wrinkles in the stockings.
- Discard gloves if wearing and wash your hands.
- If the stockings do not appear to fit well and appear to be digging into the top of the patient’s leg, inform a supervisor right away. The patient may need to be refitted for the appropriate sized stocking.
- Stockings should be removed and skin should be cleaned, dried, and inspected at least once per day.
- Observe for changes in skin color, temperature, swelling, sores on legs, and patient complaints.
- Document and report any changes in condition or behavior.