Schools of Health and Allied Health Sciences

College of Nursing

LEVEL 1
NUR 092
2nd Semester
SY: 2023 – 2024

Name: ______________________________ Group: ________ Date: __________ Rating: ________

PERFORMANCE CHECKLIST IN TRANSFER FROM BED TO CHAIR AND FROM CHAIR TO BED

CRITERIA
4 3 2 1
Proficient Approaching Developing Beginning
Proficiency
PROCEDURE Independently Performs skills with Performs skills Performs skills
performs all skills assistance of faculty with assistance of with assistance
fluently and 1 - 2 times during faculty 3 - 4 times of faculty greater
without difficulty. simulation. during simulation than 4 times
during simulation
PREPARATION
ASSESSMENT:
1. Explain the steps to
the patient.
2. The following equipment
is needed for this skill:

a. wheelchair or chair
b. transfer or gait belt.

A. Moving From Bed to

Wheelchair

PLANNING
3. Position wheelchair or chair
on the patient’s strongest side
at 45-degree angle or parallel to
bed.
4. If transferring to a
wheelchair, adjust footrest and
lock brakes.

IMPLEMENTATION:

5. Lock bed brakes, lower bed

to lowest position, and raise the
head of bed as far as patient
can tolerate
6. Assist patient to side-lying
position. Lower side rail and
stand near patient’s hips with
foot near head of bed in front of
and apart from other foot.
7. Swing patient’s legs over
bed. At the same time, pivot
your back leg to lift patient’s
trunk and shoulders. Keep back
straight and avoid twisting.
Support patient’s upper back as
they come to sitting position
8. Stand in front of patient and
assess for balance. Support in
sitting position on the side of
bed. Have patient slide buttocks
to edge of bed until feet touch
floor. Make sure patient has
non-skid soles on shoes or
socks.
9. Have patient place their
hands on your shoulders or on
the mattress on either side of
their body.
10. Place your hands under
patient’s arms. Brace your
knees against patient’s knees
as patient stands.
11. Pivot on back foot until
patient feels wheelchair or chair
against back of legs. Keep your
knee against patient’ knees.
Move slowly.
12. Have patient grasp
armrests.
13. Flex your knees and hips
while assisting patient into
wheelchair or chair.
14. Adjust footrest and leg
supports if using a wheelchair.
15. Assess patient’s alignment
and make patient comfortable.
B. Moving From Chair to
Bed
1. Bring the wheelchair
beside the bed. Make
sure the person’s strong
side is beside the bed.
Lock the brakes.
2. Put both feet flat on the
floor. Move the footrest(s)
out of the way.
3. Ask the person to move
forward in the wheelchair.
Make sure their toes are
under their knees.
4. Stand in front of the
person. Ask them to sit
tall, lean forward and push
down on
the wheelchair armrest
as you help them to
stand.
5. Place your hands around
their upper back. If they
have a weak arm, place
your arm around it, not
under it. Do not pull on the
weak arm.
6. Help the person to move
their feet until their bottom
is over the edge of the
bed.
7. Help them sit down. The
person should:
• Reach for the bed
• Bend knees
• Keep shoulders
forward
EVALUATION:
Document patient’s response
and mobility status.
 RATING RATING RATING RATING

TOTAL: 80

Instructor’s Comments:
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____________________________________________
Signature over Printed name of the Student

____________________________________________
Signature over Printed name of the Clinical Instructor

Prepared:
Cherry Joy H. Datan, RN, MAN, Ed.D
Level I – Coordinator

Noted:
Jill Marie C. Hermogenes, RN, MAN, Ed.D
Assistant Dean

Approved:
Michelle B. Yu, RN, MAN, DM
Dean