Antiembolytic Stockings (Elastic Stockings) 

Purpose: 

• To provide support for lower extremities. 

• To aid return circulation from lower extremities. 

• To prevent embolus formation. 

• To reduce pain. 

• To reduce edema. 

Equipment: 

• Antiembolytic stockings of correct length and size, as ordered. 

• Tape measure. 

• Custom-made gradient support stockings if needed. 

Procedure: 

1. Measuring for Proper Size: 

• Measure the circumference of the resident's thigh or calf to ensure proper size of stocking. 

• Notify the physician if standard sizes do not fit and obtain an order for custom-made gradient support stockings if needed. 

2. Preparation: 

• Gather all necessary equipment and take it to the resident’s bedside. 

• Protect the stockings from open skin areas and medications by using appropriate dressings. 

3. Application of Stockings: 

• Invert the stocking inside out up to the heel. 

• Pull the inverted part onto the foot, ensuring the opening in the hose is on the bottom of the foot. 

• Gradually smooth the stocking up the entire length of the leg. 

• Gently pull the stocking at the toe to loosen, ensuring there is no pressure on the toes. 

• Check the stocking at the ankle and knee to avoid bridging at these two curves. 

• Ensure the top of the stocking does not roll down, as this can restrict circulation. 

4. Monitoring and Adjustment: 

• Observe the resident for signs and symptoms of circulatory problems, including: 

• Color of toes 

• Temperature 

• Pain 

• Edema 

• Remove stockings as ordered and at least once daily, unless contraindicated, to inspect the condition of the skin. 

5. Post-Application Care: 

• Leave the resident comfortably positioned with the call light within reach. 

Compliance and Documentation: 

• Adhere to CMS guidelines and Requirements of Participation for Long-Term Care Facilities. 

• Document the measurement, application, and any observations related to the use of antiembolytic stockings in the resident’s care plan. 

• Regularly review and update techniques and protocols for the use of antiembolytic stockings according to the latest clinical best practices and regulatory standards. 

• Provide training to staff on the correct measurement, application, and monitoring of antiembolytic stockings to ensure resident safety and comfort. 

• Conduct regular audits to ensure compliance with this policy and address any gaps in practice or documentation. 

References: 

• Centers for Medicare & Medicaid Services (CMS). State Operations Manual (SOM), Appendix PP - Guidance to Surveyors for Long-Term Care Facilities. 

• CMS Requirements of Participation for Nursing Homes.