Gait Belts Are a Part of Physical Therapy
I heard something I couldn't believe at our last monthly staff meeting. The department director questioned the use of gait belts. He said there was no written policy for our department stating gait belts must be used. He went on to say that some in the PT profession believe we shouldn't be using them because they are causing injuries.
Not use a gait belt? I couldn't believe what I just heard. I've always used a gait belt. Everyone I know has always used a gait belt. OTs use them. Nurses use them. I thought using a gait belt was a fundamental component of what we do. I can remember being taught in PT school many years ago the importance of gait belts for safety and body mechanics.
I would understand a discussion concerning gait belts and infection control. I'm waiting for that to be an issue. This hospital's policy is now hand washing before entering a room as well as upon leaving it. I often wonder how infection-control nurses ignore our belts. We wear them around our waists. We use the same belt on nearly every patient. Most gait belts are canvas which is difficult to clean and obviously means the belt isn't cleaned between uses. Other than some facilities issuing each patient his or her own belt, I've never seen it addressed. I was surprised to hear the problem wasn't infection control, but therapist and patient injury.
According to our director, therapists are injuring their arm holding the belt due to the long-lever arm. Further, their ability to prevent falls is in question. He said this is a huge issue in PT literature. I'm pretty up on PT literature and this is the first I've heard of this. So, I did some research. I asked PTs who work in other facilities about gait belts. Everyone used one. No one had heard of this. Next, I checked the literature. This is the era of evidence-based practice. I thought use of gait belts would fall under the "doh" part of evidence since PTs have been using them from practically the dawn of time. If this man is correct, I thought I would easily find the evidence.
I searched two major data bases as well as the APTA data base. We can take a collective sigh of relief. I found nothing supporting not using gait belts. I found nothing describing injuries to therapists or patients from using them. I found no articles or editorials arguing against them. I found the opposite. An article addressing fall prevention stated: the question after a fall isn't whether a gait belt should be used, but if it was used.1 A second discussed how the majority of nursing schools have joined PT schools in teaching the use of gait belts for patient transfers.2 Yet another pointed out gait belts have dual functions. Using gait belts allows patients to be moved safely and prevents staff injuries.3 A pilot study looked at using them for fall prevention. It found the use of gait belts increased safety and decreased costs. Their use eliminated unnecessary grasping of patient body parts and allowed the consistent application of body mechanics.4
I feel better. An icon of physical therapy is safe. Taking my gait belt away would have felt like losing a limb. I would no longer have been able to amaze people by transferring patients twice my size with ease. The task of lowering someone to the floor would have become significantly more difficult. I don't know what the director was talking about or what his source was. I'm going to ask him now that I've done my research. Whenever I put my belt around someone I explain it's a safety precaution and makes me feel better. Many patients thank me for doing so because it also makes them feel better. That's a stronger argument than all the evidence I found combined.
1 "Legal Eagle Eye Newsletter for Nsg Profession" 2004, Aug:14 (8)
2 "Research in Nursing and Health" 19999 Feb 22 (1)
3 "Nursing Homes" Jan 1997 Vol 46 (1)
4 "Pcci[atopma; Jea;tj amd Safety" Mar 1997 Vol66(3)