Patient Transfer for Health Care
Professional
Objectives
Discuss safety pertaining to patient transferDiscuss levels of transfer and assistanceDiscuss proper body mechanicsDiscuss examination before patient transferReview of main transfer equipmentReview procedure of care to treatment table
transferReview procedure of three person carryReview procedure of sliding board and wheel
chair transfer
Generalizability and Examination
The goal of transfer training is generalizability
Generalizability means that some skills learned for one transfer can be used for other transfers
Patients should be accessed for function capabilities before transfer as noted below: Strength Range of Motion Pain Cognitive abilities Movement dysfunction
Safety First
Safety must never be compromisedNever select method of transfer by easeWhen in doubt always obtain helpAlways stabilize equipment (lock..)Secure all lines when transferringUse proper body mechanics
Levels of Transfer
Independent Transfer: Patient is able to perform All aspects of transfer
WITHOUT assistance by additional personnel
Assisted Transfer: Patient participates actively with some assistance
from personnel
Dependent Transfer: Patient DOES NOT participate actively or participate
in transfer
Levels of Assistance
Standby Assistance: - patient is able to perform transfer on their own, but may require some verbal cues
Close guarding: patient is able to perform transfer on their own, but may be limited by their balance and limited strength
Contact guarding: patient is able to perform transfer with minimal assistance – constant contact should be used to insure safety
Level of Assistance Continued
Minimal assistance: patient can perform at least 75% of the activity
Moderate assistance: patient can perform at least 50% of the activity
Maximum assistance: patient can perform less than 25% of the activity
Amount of Assistance
Level of assistance changes as patient’s condition changes
When more than one person is required for transfer utilize moderate x2 assist (for example)
Body Mechanics
Create a good base by keeping feet at shoulder width
Keep back uprightBend at kneesBe attentive to center of mass and base of
support – reduces strain on back and upper extremities
Control appropriate aspect of patient’s anatomy to provide support Under buttocks for lifting Behind hips for moving patient into your base of
support
Preparing the Environment
Consideration of direction of transfer from LEFT to RIGHT or RIGHT to LEFT
Moving patient to their STRONGER SIDE is the easiest (also bolster’s patient’s confidence level)
Personnel performing transfer should avoid wearing jewelry that can entangle or scratch patients during patient care
All equipment should be ready BEFORE transfer begins Example: coordinate with floor nurse prior to transfer
Instructions and Verbal Cues
Clear and define instruction should be verbalized clearly to patient and assistant(s)
Patients feel comfortable knowing what is about to take place
Never move patient on a number INSTEAD use actions words as noted below: “I will count to three and then give the command to lift” “When I say “lift”, we will “lift” The lead should visually and verbally check to make
sure the patient and assistant are ready The leader says “One, two, three, lift”
Equipment
Some equipment used in patient transfers: Wheelchairs Cart or trolley Hydraulic lift Gait belts Sliding board
Gait Belts
Gait, transfer belts can wrap around the waist of the patient providing handles for the personnel to grasp when assisting or transferring a minimal assist patient
Small hand-hold slings that go around the patient can aid in transfer by providing handles
Handles improves the grasp opportunity for personnel and thereby reduces accidents and possible skin shearing…tearing
Hydraulic Lift
Used to transfer patients to chairs and bedsHelpful in moving difficult transfer patients
(obese)450 pound capacity on average
Sliding Board
Sliding boards are usually made of a smooth rigid material
Sliding boards vary in shape and material
Boards act as a supporting bridge when seated slide transfers are performed
Sliding Board with Wheel Chair
Wheelchair and table are parallel, or at a slight angle
Wheels locks are engagedSliding board is placed under patient
buttocks to the chairPatient DOES a series of push ups, with
guidance from personnel, sliding into the wheelchair
Patient leans AWAY from the wheel chair and board is removed
Vise-versus from chair to table
Sliding Transfer (Cart to Treatment Table)
Draw sheet is placed under patientSides of sheet are rolled and grasped close to patientLeader should be near patient’s headIt patient is unable to control their head and neck, then the
leader should place one arm under the patient’s should while cradling the patient’s head
If movement cannot be controlled or if a patient is agitated, a sheet may be wrapped around patient for better control
Place cart and table side by side with leader at head, assistant controls LE, and other assistant control other side
On leaders command move patient (may kneel on table if cannot reach across)
Three person carry
Tallest person (if strong enough) is at the head All three movers on the same sideSupport head and UE, midsection and LEUpon command patient is moved to the edge of the cartFlex patient’s elbows – roll on his side, facing personnelUpon command patient is liftedUpon command personnel walks backward to pivot 90
degrees or until patient is aligned with treatment tableUpon command personnel flex their legs until elbows
rest on edge of table then uncradle slowly and align patient
Summary
Before transferring patient, examine patient strength, ROM, pain cognitive abilities, skin integrity, and movement dysfunction
Safety of patient and staff is priorityGait belts, sliding boards, hydraulic lift, wheel
chairs, and carts are main transfer equipmentKnowledge level of transfers and assistances will
aid staff to evaluate appropriate transfer techniqueProper body mechanics must be adhered toAppropriate steps should be taken based on the
type of transfer
Question 1
Body mechanics ensures the safety of the _________?
A. PatientB. Staff membersC. EquipmentD. Both A and B
Answer (Question 1)
Both A and B
Which is NOT an important factor for safe transfers?
A. Safety must never be compromisedB. Always select method of transfer by easeC. When in doubt always use an assistantD. Use proper body mechanics
Answer (Question 2)
B. Always select method of transfer by ease
Question 3
Never consider the direction of transfer (Left to Right or Right to Left).
Answer (Question 3)
False
Question 4
Moderate assistance refers to the patient’s being able to perform at least _______ of the activity.
A. 15%B. 25%C. 50%D. 75%
Answer (Question 4)
C. 50%
Question 5
True or False:
Staff should never discuss plan of transfer in the presence of patient because it increases the patient’s anxiety level?
Answer (Question 5)
False
References
www.gendronine.comwww.meiresearch.orgwww.okcareertech.orgDuesterhaus Minor, M.A. and Duesterhaus
Minor, S. (2006). Patient Care Skills, 5th ed. Upper Saddle River, NJ: Pearson
Top Related