unit 16

Unit 16

The Patient’s Mobility:Transfer Skills

LET’S GET MOVING!

Introduction

• As a nursing assistant, you will work with many patients who have impaired mobility.

• In the last unit, you learned how to move and position patients in bed.

• In this unit, you will learn how to transfer patients.

Nursing Assistant Safety

• Patient lifts and transfers are listed as tasks with the highest risk of injury because:– Workers end up in awkward positions

and confined spaces– Workers are bending or reaching while

the back is flexed

• Factors that further increase the risk of injury are:– Patient weight– Transfer distance– Confined workspace– Lateral patient transfers– Unpredictable patient behavior– Stooping, bending, and reaching

• Although the nurse or therapist selects the method of transfer– You will need to determine if you will need

another person or piece of equipment to assist you

• Key elements for you to consider are:– Patient’s ability to assist with the procedure– Patient’s ability to bear weight– Patient’s upper extremity strength– If a sliding board or certain other transfers

are used

• Key elements for you to consider are:– Patient’s ability to cooperate and follow

directions– Patient’s size (height and weight)

compared with your size

• Key elements for you to consider are:– If the patient is larger than you are

• You may need help from another assistant or a mechanical device

– If the patient is smaller than you are, is dependent, or cannot cooperate• You may also need help

• Key elements for you to consider are:– Wounds– Surgical sites– Catheters, IVs, tubes, contractures, etc.

that restrict or interfere with mobility• Always get help if there is danger of removing a

tube during transfer

• Key elements for you to consider are:– Special physician orders or therapy

recommendations for transfers and positioning• Such as you would see in a patient who has

had hip surgery

Nursing Assistant Safety• Some facilities have implemented “no

lift” policies– “No manual lifting” should be done

Need a Lift?

Nursing Assistant Safety• Facilities with “no lift” or “zero lift”

policies – Usually depend on mechanical aids to

reduce friction when moving a patient

Nursing Assistant Safety• Some use a combination of mechanical, electrical,

and ceiling-mounted lifts for moving patients vertically • Many facilities require the use of gait belts

Types of Transfers

• Basic types of transfers are:– Standing transfer– Sitting transfer– Lateral transfer– Vertical transfer

• Done with a mechanical lift

Transfers• A transfer belt

– Webbed belt 1½ to 2 inches wide and about 54 to 60 inches long

– Assistive and safety device used to transfer or ambulate patients

Transfers• During transfer and when wheelchair is parked

– Always position small front wheels facing forward and lock brakes

• Refer to Figure 16-2

Transfers• A sliding board is a plastic or wooden

board that is about two feet long with a slippery surface

Stretcher Transfers• To move a patient from his or her room to

another room for surgery, treatment, or diagnostic testing

• Procedure may be very frightening to the patient– Assure patient that procedure is safe

Moving the Patient with a Mechanical Lift• For moving heavy patients who have little or

no ability to assist• Safer for both the patient and nursing

assistant

Moving the Patient with a Mechanical Lift• Moves patient from one surface to another by

means of a vertical transfer• Many types of mechanical lifts are used

Toilet Transfers• Bladder is emptied much more efficiently if a

patient can use a toilet or commode rather than a urinal or bedpan

• To use the toilet– Patient must possess transfer skills

Tub Transfers• In the institutional setting

– A shower with chair or a tub with hydraulic lift is available

• If the patient is at home– A tub chair, a rail on the wall beside the

tub, and slip-proof mats in the tub are needed for safety

Car Transfers• You may need to assist a patient

– Transferring into a car when he or she is discharged from the hospital

• If you are working in the patient’s home– It may be your responsibility to assist the patient

when going in and out of a car

Tip #1 Keep the sitting surfaces equal. Tip #2 Remember friction in physics? - lessen the friction involved. Tip #3 Slide the car seat all the way back AND... Tip #4 Instead of wedging yourself in the crux of the door and the car... Tip #5 The steering wheel is a sturdy "grab bar" - use it wisely. Tip #6 Pull instead of push.

Manual Wheelchair to Car Tips

unit 16

delmar learning

patient copyright

patients mobility

position patients

combination of mechanical

procedurepatients ability

mechanical aids

mechanical deviceif

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