Professional Documents
Culture Documents
DAMAGE
Use a transfer board or draw sheet
Lift client instead of sliding across surfaces
Pad surfaces that may cause injury (e.g., bed rails)
FOOT INJURY
Place nonskid slippers on client
Do not tuck sheets/blankets tightly over feet
Ensure that feet do not become tangled in side rails, chair legs, or other
equipment
DISLODGING CLIENT
Assess for presence of all tubes and care equipment lines (e.g., catheters, IV
lines)
Determine if equipment must be temporarily disconnected during the transfer
Reconnect equipment promptly when transfer is completed
Keep the urinary drainage bag at a level lower than the bladder
A. Transferring from Bed to Chair
A client may need to be moved from the bed to a chair, commode, or wheelchair.
A wheelchair is a means of transportation for clients unable to support their weight
while standing. Safety instructions for use of a wheelchair include the need to keep
the wheels locked when not deliberately moving and to move the footrests out of
the way when getting in and out of the wheelchair.
Wheelchair Technique
When pushing a wheelchair, back into and out of elevators.
Back slowly down wheelchair ramps.
Push the wheelchair ahead of you when going up ramps.
If going through a self-closing door, back the wheelchair out of the room. You
can keep the door open by backing against the door. The wheelchair can then
be guided out of the room.
Lock brakes when the wheelchair is standing still.
Intravenous infusion bags can be placed on portable IV poles attached to the
wheelchair during transport.
Urinary drainage bags can be placed on the lower body of the wheelchair
during transport.
Coil the drainage tubing so the catheter is not tugged during transport.
Empty urinary drainage bag prior to wheelchair transfer.
Keep the urinary drainage bag below the level of the clients urinary bladder.
B. Transferring from Bed to Stretcher
Some clients (e.g., those who are too weak to sit upright, those who are
unconscious, or those with injuries prohibiting the erect position) must lie flat during
transfers.
Assistive Devices
There are several devices available for helping with client transfers. Slide boards or
transfer boards assist the bed-wheelchair transfer by bridging the same level space
between the bed and the wheelchair. Note that specialized wheelchairs with
removable armrests are used with slide boards. As the client becomes more
independent, the slide board can be used to transfer from wheelchair to car.
Other transfer appliances include stretchers (gurneys) and hydraulic lifts. The
hydraulic (Hoyer, mechanical) lift is used for moving immobile clients who are
obese. A client may be transferred to a chair, wheelchair, bedside commode,
stretcher, or scale using a hydraulic lift.
The manufacturers equipment instructions should be followed and the weight limits
must not exceed the manufacturers specifications. Two staff members are needed
to safely operate a hydraulic lift. Hydraulic lifts are not for use with clients who have
spinal cord injury as spinal alignment is not maintained during use of the lift.
Action
Rationale
Transferring a Client from Bed to Chair
Equipment
Bed
Wheelchair/commode/chair
1. Inform client about desired purpose
and destination.
2. Assess clients ability to assist with
the transfer and for presence of
cognitive or sensory deficits.
3. Lower the bed.
4. Allow client to dangle for a few
minutes.
5. Bring wheelchair close to the side of
the bed, toward the foot of the bed.
6. Lock wheelchair brakes and elevate
the foot pedals.
7. Assist client to side of bed until feet
touch the floor.
8. Assess client for dizziness. Remain in
front of client until dizziness has
subsided. Apply gait belt if necessary.
9. Reach under clients axillae and place
hands on clients scapulae (or grasp gait
belt).
10. Assist the client to a standing
position and provide support.
11. Pivot client so clients back is toward
the wheelchair.
12. Instruct client to place hands on the
arm supports of the wheelchair.
be seated.
12. Allows client to gain balance and
judge distance to seat.
clients head.
6. Logroll the client and place a lift sheet
under the clients back, trunk, and upper
legs. The lift sheet can extend under the
head if client lacks head control abilities.
7. If urinary drainage bag is present,
empty it and move it to side of bed
closest to stretcher.
8. Move client to edge of bed near
stretcher.
9. Caregiver on non-stretcher side of
bed holds the lift sheet across the
clients chest.
10. Place pillow overlapping the bed and
stretcher.
11. Position client on stretcher and
cover with a sheet or bath blanket.
move.
6. Prevents flexion and rotation of
clients hips and spine; maintains correct
body alignment.
NAME:
DATE:
Transferring a Client from Bed to Chair
5
1. Inform client about desired purpose and destination.
2. Assess clients ability to assist with the transfer and for presence
of cognitive or sensory deficits.
3. Lower the bed.
4. Allow client to dangle for a few minutes.
5. Bring wheelchair close to the side of the bed, toward the foot of
the bed.
6. Lock wheelchair brakes and elevate the foot pedals.
7. Assist client to side of bed until feet touch the floor.
8. Assess client for dizziness. Remain in front of client until dizziness
has subsided. Apply gait belt if necessary.
9. Reach under clients axillae and place hands on clients scapulae.
10. Assist the client to a standing position and provide support.
11. Pivot client so clients back is toward the wheelchair.
12. Instruct client to place hands on the arm supports of the
wheelchair.
13. Bend at the knees, easing the client into a sitting position.
14. Assist client to maintain proper posture.
15. Secure the safety belt, place clients feet on feet pedals, and
release brakes.
Transferring a Client from Bed to Stretcher with Minimum
5
Assistance
1. Inform client about desired purpose and destination.