TRANSFER

OVERALL OBJECTIVE

 Totransfer patient from a bed to a chair,

wheelchair, commode, or stretcher with
maximum comfort and safety for the
patient and nurse.
SPECIFIC OBJECTIVES
 Assessa patient to determine ability to move,
bear weight and maintain balance.
 Analyze data to identify whether the patient can
participate in the transfer process.
 Determine appropriate patient outcomes related
to transfer and recognize the potential for
adverse outcomes.
 Plan an effective transfer technique for the
individual patient.
 Cary put a variety of different transfer techniques
safely for the patient and the nurse.
 Use appropriately selected lift devices to assist in
the transfer of patients.
 Evaluatethe effectiveness of the transfer
technique used.
 Document the transfer technique used and the
patient’s response
 Moving patients out of bed is beneficial for them.
 Movement maintains and restores muscle tone
 Stimulates the respiratory and circulatory systems
 Improves elimination
 Patients need only dangle their legs over the side
of the bed or sit in a chair at the bedside for a
few minutes to improve their physical and
psychological well-being.
 Ergonomics – science of fitting a job to a person’s
anatomic and physiologic characteristics to
enhance efficiency and well-being.
 Many clients cannot move at all or need
assistance in moving: transferring between bed
and chair or wheelchair, between wheelchair and
toilet, between bed and stretcher; transfer for
the purposes of care, transport for therapies and
tests, and change of patient’s positions.
TRANSFER

 Moving from one place to another

 Before transferring any client, the nurse must:
 Determine the client’s physical and mental capabilities
to participate in the transfer technique
 Analyze and organize the activity.
 During transfer, keep patient safe while
protecting oneself from injury.
 Gait belt/transfer belt/walking belt
 Suitablefor clients who can bear weight and require only
minimal assistance
 Should not be used to lift a client off the floor or for
bariatric clients
 Use for transfer falls into either a moderate or high-risk
category for low-back disorders
 Can have handles that allow the nurse to control movement
of the client during transfer or during ambulation.
 Sliding
board – made of low-friction materials or with
movable sliding sections
 Can be used to transfer a client between a bed and chair
General guidelines for transfer
technique
 Plan what to do and how to do it.
 Obtain essential equipment before starting and
check that all equipment are functioning
correctly.
 Remove the obstacles from the area used for the
transfer.
 Explain the transfer to the client including what
the client should do.
 Explain the transfer to the nursing personnel who
are helping: specify who will give directions (one
person needs to be in charge).
 Always hold/support the client farther than the
equipment and ensure the client’s safety and
dignity.
 During the transfer, explain step by step what the
client should do, for example, “Move your right
foot forward.”
 Make a written plan of the transfer, including the
client’s tolerance (e.g., pulse and respiratory rates)
WHEELCHAIR SAFETY
 Alwayslock the brakes on both wheels of the
wheelchair when the client transfers in or out of
it.
 Raise the footplates before transferring the client
into the wheelchair.
 Lower the footplates after the transfer, and place
the client’s feet on them.
 Ensure the client is positioned well back in the
seat of the wheelchair.
 Useseatbelts that fasten behind the wheelchair
to protect the confused clients from falls. Note:
Seatbelts are a form of restraint and must be used
in accordance with policies and procedures that
apply to the use of restraints.
 Back the wheelchair into and out of an elevator ,
rear large wheel first.
 Place
you body between the wheelchair and the
bottom of an incline.
SAFE USE OF STRETCHERS
 Lockthe wheels of the bed and stretcher before
the client transfers in or out of them.
 Fastensafety straps across the clients on a
stretcher, and raise the side rails.
 Never leave a client unattended on a stretcher
unless the wheels are locked and the side rails are
raised on both sides and/or the safety straps are
secured across the client.
 Always push a stretcher from the end where the
client’s head is positioned. This position protects
the client’s head in the event of a collision.
 Ifthe stretcher has two swivel wheels and two
stationary wheels:
 A. always position the client’s head at the end
with the stationary wheels
 B. Push the stretcher from the end with the
stationary wheels. The stretcher is maneuvered
more easily when pushed from this end.
 Maneuver the stretcher when entering the
elevator so that the client’s head goes in first.
 TRANSFERRING
BETWEEN BED AND
CHAIR
PURPOSE:

A client may need to be transferred between a

bed and a wheelchair or chair, the bed and the
commode or a wheelchair and the toilet
ASSESSMENT
 The client’s body size
 Ability to follow instructions
 Ability to bear weight
 Ability to position/reposition
feet on the floor
 Ability to push down with arms
and lean forward
 Ability to achieve independent
sitting balance
 Activity tolerance
 Muscle strength
 Joint mobility
 Presence of paralysis
 Level of comfort
 Presence of orthostatic
hypotension
 The technique with which the
client is familiar
 The space In which the transfer
will need to be maneuvered
 The number of assistants
needed to accomplish the
transfer safely
PLANNING
 Review the client’s
record.
 Gather needed
equipments:
-robe or appropriate
clothing
-non-skid shoes or
slippers
-Gait/ transfer belt
-chair/ commode/
wheelchair as appropriate to
client need
Implementation
 Introduce self, verify the client’s
identity. Explain the transfer process to
the client
 Hand hygiene and appropriate infection
prevention procedures.
 Provide for client privacy
 Position the equipment
appropriately:
-lower the bed to its lowest possible
position---client’s feet will rest flat on
floor; Lock the wheels of the bed
-Place the wheelchair parallel to the
bed and as close to the bed as
possible. Put the wheelchair on the
side of the bed that allows the client to
move toward his/her stronger side. Lock
the wheels and raise the footplate.
 Prepare the client:
 Assist the client in sitting
position on the side of the bed.
 Assess for orthostatic
hypotension before moving the
client from the bed.
 Put on bathrobe and nonskid
slippers/shoes
 Place gait/ transfer belt snugly
around the client’s waist.
 Give explicit instructions to
the client:
 Have the patient move forward
and sit on the edge of the bed
with feet placed flat on floor.
This brings the client’s center of
gravity closer to the nurse.
 Lean forward slightly from hips.
This brings the client’s center of
gravity more directly over the base
of support and positions the head
and trunk in the direction of the
movement.
 Place the foot of the
stronger leg beneath
the edge of the bed
and put the other foot
forward.
In this way, the client
can use the stronger leg
muscles to stand and
power the movement. A
broader base of support
makes the client more
stable during the
transfer.
 Place the client’s
hand on the bed
surface so that the
client can push on
standing
This provides additional
force for the movement
and reduces the
potential for strain on
the nurse’s back
 Position yourself correctly:
 Stand directly in front of the
client and to the side requiring
the most support.
 Hold the gait/transfer belt with
the nearest hand; the other hand
supports the back of the client’s
shoulder.
 Lean your trunk forward from
hips. Flex your hips, knees and
ankles.
 Assume broad stance, placing one
foot forward and one back. Brace
the client’s feet with your feet to
prevent the client from sliding
forward or laterally.(Mirroring)
>Assist the client to stand, and
then move together toward
the wheelchair/ sitting area

 Verbal instructions:
- On the count of three
 “stand”
 Support the client in upright
position for few moments
 Together, pivot on your foot
farthest from the chair , or
take a few steps toward the
wheelchair, chair/ commode
Assist the client to
sit.
 Have the client back up to
the wheelchair and place
the legs against the seat.
To minimize the risk of the
client falling when sitting
down.
 Have client hold the arms
of the wheelchair.
 Tighten your grasp on the
transfer belt, have the
client sit down while you
bend your knees/hips and
lower the client onto the
wheelchair seat.
Ensure client’s safety.
 Ask the client to push back into
the wheelchair seat.
 Remove the gait/ transfer belt.
 Lower the footplates, and place
the client’s feet on them, if
applicable.
Links

 https://www.youtube.com/watch?v=JZPh9uK30eQ&t=29s TRANSFER