It's easier to put the belt on properly if the patient is seated upright with their feet flat on the floor and their arms to their sides (but not right up against their body). This is also the best position for using the gait belt to help move a patient from a bed or chair to a wheelchair or other seat. Gait belts are most effective when used on patients who are able to sit upright, but who need assistance standing and moving to a nearby seat. Ask the patient to lift their arms slightly if necessary, then wrap the belt around their midsection, right over their clothing. However, make sure there are no medical tubes or wires—for instance, an oxygen tube—running underneath the belt. If there are any wires or tubes in the way, carefully feed the belt underneath them, so the belt is between the tube/wire and the patient's clothing. The belt should not wrap right over the patient's hip bones, or around the bottom of their ribcage. Make sure it's wrapped over their waistline, so that the bottom of the belt is just at the tops of their hip bones. Feel for the hip bones to confirm the belt is in the right location. Standard gait belts use a metal buckle with a loop at each end, one of which has gripping teeth inside the loop. Position the belt and buckle so that, when the strap is wrapped around the patient's body, the first loop it encounters is the one with the teeth.  The teeth should also be pointing outwards, away from the patient's belly, not inwards towards it. Not all gait belts have metal buckles with teeth. Quick-release belts, for instance, often have plastic buckles that snap together.

Summary:
Have the patient sit upright on the edge of the bed or chair. Wrap the belt over clothing but not any tubes or wires. Position the belt at the waist, just above the hips. Make sure the teeth of a standard belt are in the right spot.