Patient Transferfor

Health Professional

Objectives

Discuss safety pertaining to patient transferDiscus levels of transfer and assistanceDiscuss proper body mechanicsDiscuss examination before patient transferReview of main transfer equipmentReview procedure of cart to treatment table

transferReview procedure of three person carryReview procedure of sliding board with wheel

chair transfer

Generalizability and Examination

The goal to transfer training is generalizabilityGeneralizability means that some skills learned

for one transfer can be used for other transfersPatients should be accessed for function

capabilities before transfer by some examinations: Strength Range of motion Pain Cognitive abilities Movement dysfunctions

Safety First

Safety must never be compromised Never select method of transfer by easeWhen in doubt always use an assistantAlways stabilize equipment (use wheel

locks)Secure all lines when transferringUse proper body mechanics

Levels of Transfer

Independent transfer: patient is able to perform all aspect of transfer without assistance by additional personnel

Assisted transfer: patient participate actively with some assistance form personnel

Dependent transfer: patient does not participate actively or participate on minimal basis

Levels of Assistance

Standby assistance – patient 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 have a likelihood for needing physical assistance such as balance or support

Contact guarding – patient is able to perform transfer with minimal assistance; constant contact should be used to insure safety

Minimal assistance – patients who 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 condition changes

When more than one person is required for transfer chart will indicate Example: Moderate x2

Body Mechanics

Create a good base by keeping feet at shoulder width

Keep back uprightBend at kneesAttention to center of mass and base of support

reduces strain on staff member(s) back and upper extremities

Control appropriate aspect of patient’s anatomy to provide support Under buttocks for lifting Behind the 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 a patient’s confidence)

Personnel performing transfer should avoid wearing jewelry that can entangle or scratch patients during patient care

All equipment should be ready before transfer begin Example: Speak to floor nurse to prepare

Instructions and Verbal Cues

Clear and define instruction should be verbalized clearly to patient and assistance(s)

Patients feel comfortable knowing what is about to take place

Never move patient on a number instead use action words example:1. “ I will count to three and then give the command to

lift”2. “When I say ‘lift,’ we will lift.”3. The leader should visually and verbally check to

make sure that patient and assistance are ready 4. The leader says “ One, two, three, lift”

Equipment

Some equipment used in patient transfers:WheelchairsCart or Trolley Hydraulic liftGait beltsSliding board

Sliding Board

Hydraulic Lift

Use to transfer patients to chairs and beds

Helpful in moving difficult transfer patients (Especially with overweight patients)

450 pounds capacity on average

Gait Belts

Gait/transfer belts can wrap around the waist of a patient providing handles for a worker to grasp when assisting or transferring a partially dependent patient

Small hand-held slings that go around the patient can aid in transfer by providing handles

Handles improves the grasp opportunity for the worker and thereby reduces the risk of accidents

Gait/transfer belts can wrap around the waist of a patient providing handles for a worker to grasp when assisting or transferring a partially dependent patient

Small hand-held slings that go around the patient can aid in transfer by providing handles

Handles improves the grasp opportunity for the worker and thereby reduces the risk of accidents

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

Wheel locks are engagedSliding board is placed under patient buttocks to

the chairPatient does a series on push ups, with guidance

from the technician, sliding into the wheelchairPatient leans away from the wheel chair and

board is removedVise-versus from chair to table

Sliding Transfer (Cart to Treatment Table)

Draw sheet is placed under the patientSides of sheet is rolled and grasped close to the

patientLeader should be near patients headIf patient is unable to control their head and neck,

then leader should one arm under the patient’s shoulders 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 controlling lower extremities, and other assistant on the other side

On leaders command move patient (may kneel on table if can not reach across.)

Three Person Carry

Tallest, if strong enough, at the headAll three movers on the same sideSupport the head and upper extremities, midsection,

and lower extremitiesUpon command patient is moved to the edge of the cartBy flexing elbows patient is rolled on to his side, facing

personnelUpon command patient is liftedUpon command personnel walk backward to pivot 90

degrees or until patient is aligned with treatment tableUpon command personnel flex their legs until elbows

rest on the edge on the table then uncradle slowly and align patient

Summary

Before transferring examine patient strength, range of motion, pain, cognitive abilities, and movement dysfunction

Safety of patient and staff should be prioritizedGait belts, sliding boards, hydraulic lift, wheel chairs, and

carts are main transfer equipment Knowledge levels of transfer and assistances will aid

staff evaluate transferProper body mechanics should always be used in

transfersSteps should be followed when transferring patient from

cart to treatment table Steps should be followed when transferring patient by

means of three person carrySteps should be followed when transferring patient to

wheelchair using a sliding board

Question 1

Body mechanics ensures the safety of the_______.

A. PatientB. Staff memberC. EquipmentD. Both A and B

Answer (Question 1)

D. Both A and B

Question 2

Which is not an important factor in safe transfers?

A. Safety must never be compromised B. Always select method of transfer by easeC. When in doubt always use an assistantD. Always stabilize equipmentE. Use proper body mechanics

Answer (Question 2)

B. Always select method of transfer by ease

Question 3

True or False?

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 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 presents of patient because it brings anxiety to the patient

Answer (Question 5)

False

References

www.gendroninc.comwww.meiresearch.orgwww.okcareertech.orgDuesterhaus Minor, M.A. and Duesterhaus

Minor, S. (2006).Patient Care Skills fifth edition. Upper Saddle River, NJ: Pearson