TRANSFERRING

BETWEEN BED
AND CHAIR
 PURPOSES
- A CLIENT MAY NEED TO BE
TRANSFERRED BETWEEN THE BED
AND A WHEELCHAIR OR CHAIR, THE
BED AND THE COMMODE, OR A
WHEELCHAIR AND THE TOILET. THERE
ARE NUMEROUS VARIATIONS IN THE
TECHNIQUE.
BEFORE TRANSFERRING A
CLIENT, ASSESS THE
FOLLOWING:
- THE CLIENT’S BODY SIZE
- THE CLIENT’S ABILITY TO
FOLLOW INSTRUCTIONS
 - THE CLIENT’S
ACTIVITY TOLERANCE
- THE CLIENT’S MUSCLE
STRENGTH
- THE CLIENT’S JOINT
MOBILITY
- PRESENCE OF
PARALYSIS
- THE CLIENT’S LEVEL OF
COMFORT
- PRESENCE OF
ORTHOSTATIC
HYPOTENSION
 - THE TECHNIQUE WITH
WHICH THE CLIENT IS
FAMILIAR
- THE SPACE IN WHICH THE
TRANSFER IS MANEUVERED
 - THE NUMBER OF
ASSISTANTS NEEDED TO
ACCOMPLISH THE
TRANSFER SAFELY
- THE SKILL AND STRENGTH
OF THE NURSE(S)
IMPLEMENT PAIN RELIEF
MEASURES SO THAT THEY
ARE EFFECTIVE WHEN
THE TRANSFER BEGINS.
 MATERIALS
- Robe or appropriate
clothing
- Slippers or shoes with
nonskid soles
- Transfer (walking) belt
- Chair
 REMOVE OBSTACLES
FROM THE AREA USED
FOR THE TRANSFER.
INTRODUCE
YOURSELF
 PERFORM
HAND HYGIENE
USE CLEAN
GLOVES
PROVIDE FOR
CLIENT
PRIVACY.
 POSITION THE
EQUIPMENT
APPROPRIATELY
 LOWER THE BED TO ITS
LOWEST POSITION, SO THAT
THE CLIENT’S FEET WILL
REST FLAT ON THE FLOOR.
LOCK THE WHEELS OF THE
BED.
PLACE THE WHEELCHAIR
PARALLEL TO THE BED, AS
CLOSE TO THE BED AS
POSSIBLE. PUT THE
WHEELCHAIR ON THE SIDE
OF THE BED
PREPARE AND
ASSESS THE
CLIENT.
ASSIST THE CLIENT
TO A SITTING
POSITION ON THE
SIDE OF THE BED.
ASSESS THE CLIENT FOR
ORTHOSTATIC
HYPOTENSION BEFORE
MOVING THE CLIENT
FROM THE BED
ASSIST THE CLIENT IN
PUTTING ON A
BATHROBE AND
NONSKID SLIPPERS OR
SHOES.
PLACE A TRANSFER BELT
SNUGLY AROUND THE
CLIENT’S WAIST. CHECK
TO BE CERTAIN THAT THE
BELT IS SECURELY
ASK THE CLIENT TO
MOVE FORWARD
AND SIT ON THE
EDGE OF THE BED.
 PLACE THE FOOT OF THE
STRONGER LEG BENEATH THE
EDGE OF THE BED AND PUT
THE OTHER FOOT FORWARD.
THE CLIENT SHOULD NOT
GRASP YOUR NECK FOR
SUPPORT.
PLACE THE CLIENT’S HANDS
ON YOUR SHOULDERS, SO
THAT THE CLIENT CAN PUSH
WHILE STANDING. THE
CLIENT SHOULD NOT GRASP
YOUR NECK FOR SUPPORT.
 POSITION
YOURSELF
CORRECTLY.
STAND DIRECTLY IN
FRONT OF THE
CLIENT
ENCIRCLE THE CLIENT’S WAIST
WITH YOUR ARMS, AND GRASP
THE TRANSFER BELT AT THE
CLIENT’S BACK WITH YOUR
THUMBS POINTING
DOWNWARD.
ASSIST THE CLIENT TO
STAND, AND THEN
MOVE TOGETHER
TOWARD THE
WHEELCHAIR.
 ASSIST THE
CLIENT TO SIT.
 ASK THE CLIENT TO
BACK UP TO THE
WHEELCHAIR AND
PLACE LEGS AGAINST
THE SEAT.
 ASK THE CLIENT TO
PLACE THE FOOT OF
STRONGER LEG
SLIGHTLY BEHIND THE
OTHER.
ASK THE CLIENT TO
KEEP OTHER FOOT
FORWARD.
 ASK THE CLIENT TO
PLACE BOTH HANDS
ON THE WHEELCHAIR
ARMS OR ON YOUR
SHOULDERS.
 STAND DIRECTLY IN
FRONT OF THE CLIENT.
PLACE ONE FOOT
FORWARD AND ONE
BACK.
 ON THE COUNT OF
THREE, I WILL BE
GOING TO ARRANGE
AND POSITION YOU
PROPERLY.
ENSURE CLIENT
SAFETY.
ASK THE CLIENT TO
PUSH BACK INTO
THE WHEELCHAIR
SEAT
 LOWER THE
FOOTPLATES AND
PLACE THE CLIENT’S
FEET ON THEM.
APPLY A SEAT
BELT AS
REQUIRED.
 VARIATION:
ANGLING THE
WHEELCHAIR
FOR CLIENTS WHO HAVE
DIFFICULTY WALKING,
PLACE THE WHEELCHAIR
AT A 45-DEGREE ANGLE
TO THE BED
.
 VARIATION:
TRANSFERRING
WITHOUT A BELT
 FOR A CLIENT WHO NEEDS
MINIMAL ASSISTANCE, PLACE
HANDS AGAINST THE SIDES OF
THE CLIENT’S CHEST (NOT AT
THE AXILLAE) DURING THE
TRANSFER.
 - STAND
- SIT ON THE
WHEELCHAIR
- POSITION THE
PATIENT
 VARIATION:
TRANSFERRING A
CLIENT WITH AN
INJURED LOWER
EXTREMITY
 WHEN THE CLIENT HAS AN
INJURED LOWER EXTREMITY,
MOVEMENT SHOULD ALWAYS
OCCUR TOWARD THE
CLIENT’S UNAFFECTED
(STRONG) SIDE.
 RECORD:
-CLIENT’S ABILITY TO BEAR WEIGHT
AND PIVOT.
-NUMBER OF STAFF NEEDED FOR
TRANSFER.
-LENGTH OF TIME UP IN CHAIR.
-CLIENT RESPONSE TO TRANSFER AND
BEING UP IN CHAIR OR WHEELCHAIR.
TRANSFERRING
BETWEEN BED
AND STRETCHER
THE STRETCHER OR GURNEY, IS
USED TO TRANSFER SUPINE
CLIENTS FROM ONE LOCATION
TO ANOTHER. LIFTING ONTO IT
OR BY ROLLING ONTO IT, THE
CLIENT SHOULD BE
ENCOURAGED TO DO SO.
BEFORE TRANSFERRING A
CLIENT, ASSESS THE
FOLLOWING:
- THE CLIENT’S BODY SIZE
- THE CLIENT’S ABILITY TO
FOLLOW INSTRUCTIONS
 - THE CLIENT’S
ACTIVITY TOLERANCE
- THE CLIENT’S LEVEL
OF COMFORT
 - THE SPACE IN WHICH THE
TRANSFER IS TO BE
MANEUVERED
- THE NUMBER OF STAFF
NEEDED TO ACCOMPLISH THE
TRANSFER SAFELY
 IF INDICATED,
IMPLEMENT PAIN RELIEF
MEASURES SO THAT THEY
ARE EFFECTIVE WHEN
THE TRANSFER BEGINS.
INTRODUCE
YOURSELF
PERFORM
HAND
HYGIENE
 PROVIDE FOR
CLIENT PRIVACY.
PUT ON CLEAN
GLOVES
 ADJUST THE
CLIENT’S BED IN
PREPARATION FOR
THE TRANSFER
LOWER THE HEAD OF
THE BED UNTIL IT IS
FLAT, OR AS LOW AS
THE CLIENT CAN
TOLERATE.
 RAISE THE BED SO
THAT IT IS SLIGHTLY
HIGHER THAN THE
SURFACE OF THE
STRETCHER.
ENSURE THAT THE
WHEELS ON THE
BED ARE LOCKED
 PULL THE
DRAWSHEET OUT
FROM BOTH SIDES
OF THE BED
 MOVE THE CLIENT TO
THE EDGE OF THE BED,
AND POSITION THE
STRETCHER.
ROLL THE DRAWSHEET
AS CLOSE TO THE
CLIENT’S SIDE AS
POSSIBLE.
 PULL THE CLIENT TO THE
EDGE OF THE BED, AND
COVER THE CLIENT WITH A
SHEET OR BATH BLANKET TO
MAINTAIN COMFORT.
PLACE THE STRETCHER
PARALLEL TO THE BED,
NEXT TO THE CLIENT,
AND LOCK THE
STRETCHER WHEELS.
 TRANSFER THE
CLIENT SECURELY
TO THE STRETCHER.
PRESS YOUR BODY
TIGHTLY AGAINST
THE STRETCHER.
ROLL THE PULL
SHEET TIGHTLY
AGAINST THE
CLIENT.
FLEX YOUR HIPS AND PULL
THE CLIENT ON THE PULL
SHEET IN UNISON DIRECTLY
TOWARD YOU AND ONTO
THE STRETCHER
ASK THE CLIENT TO FLEX
NECK DURING THE
MOVE, IF POSSIBLE, AND
PLACE ARMS ACROSS
CHEST.
 TRANSFER THE
PATIENT TO THE
STRETCHER
ENSURE CLIENT
COMFORT AND
SAFETY.
 MAKE THE CLIENT
COMFORTABLE, UNLOCK
THE STRETCHER WHEELS,
AND MOVE THE STRETCHER
AWAY FROM THE BED.
 IMMEDIATELY RAISE THE
STRETCHER SIDE RAILS
AND/OR FASTEN THE
SAFETY STRAPS ACROSS THE
CLIENT.
DOCUMENT RELEVANT
INFORMATION.
 RECORD:
EQUIPMENT USED.
NUMBER OF PEOPLE NEEDED FOR
TRANSFER.
DESTINATION, IF THE REASON FOR
THE TRANSFER IS TRANSPORT FROM
ONE LOCATION TO ANOTHER.