Transferring Patients

TRANSFERRING PATIENTS
TRANSFER
 moving a client
from one place to
another
 moving a client
from bed to a
chair or stretcher
& back to bed
again
 can be active or
passive
GUIDELINES
Determine the following:
 What kind of transfer are you about to perform?
 Is the proper equipment available in the room?
 What special equipment is needed to accomplish
the transfer?
 What is patient’s size in relation to his weight?
 How much can the patient assist you?
 How much assistance do you need from others?
GUIDELINES
 Explain the transfer to the client, including
what the client should do.
 Always support or hold the client rather
than the equipment.
 During the transfer, explain step-by-step
what the client should do.
 Make a written plan of the transfer
including the client’s tolerance.
CLIENT TRANSFER: HAZARDS AND
SAFETY MEASURES
 Potential hazards
a. falling
b. skin damage
c. foot injury
d. dislodging client care equipment
SAFETY MEASURES
 Wheelchair safety
✓ When transporting using 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.
SAFETY MEASURES
 Wheelchair safety
✓ Lock brakes when the wheelchair is
standing still.
✓ IV 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.
DEVICES USED FOR
TRANSFERRING
TRANSFER BELT
SLIDING BOARDS
OVERBED TRAPEZE
HYDRAULIC LIFT
TRANSFERS
 Transferring patients from stretcher to bed

 Performing Three-person Carry From Bed to
Stretcher
 Transferring patients from bed to a wheelchair
and back to Transferring patients from bed to
chair and back to bed
TRANSFERRING PATIENTS FROM STRETCHER TO
BED
BED
1. Wash hands.
2. Provide privacy.
3. Position the stretcher next to the bed and lower the side
rail nearest to the bed.
4. Adjust the client’s bed in preparation for the transfer.
5. Stabilize the stretcher.
6. Position one caregiver at the head of the bed, one at the
foot of the bed, and one at the middle on the bed. Other
care givers can remain on the side of the stretcher with
the side rails up. The side rail can be lowered when the
transfer begins and care givers assist with the transfer.
BED
7. Loosen the sheet on the stretcher and roll the loose
edges towards patient.
8. Ask patient to place his arms across his chest.
9. Tell the patient you are going to move him towards you
on the count of three. Count one to three.
10. All three care givers should use a smooth motion at the
same time to pull the patient towards you in the bed.
Move at slow, even pace.
11. Raise the side rails on the bed and remove the stretcher
from the room.
12. Lower one side rail and help patient roll towards you.
One care giver can fanfold the sheet under the patient’s
side after lowering the opposite side rail.
BED
13. Help patient roll to the other side and
remove the sheet used in the transfer.
14. Position the patient on the pillow.
15. Cover the patient with the sheet and
blanket or spread folded at the floor of the
bed.
16. Raise the head of the bed if this is
permitted and desired by the patient.
17. Open the privacy curtain.
18. Wash hands.
Performing Three-person Carry From Bed to
Stretcher
Performing Three-person Carry From Bed
to Stretcher
1. Three nurses stand side by side by facing side of client’s
bed. The people performing the procedure should be of
equal height.
2. Each person assumes responsibility for one of three
areas: head and shoulders, hips, and thighs and
ankles.
3. Each assumes wide base of support with foot closer
to stretcher in front, knees slightly flexed.
4. Lifters’ arms are placed under client’s head and
shoulders, hips, and thighs and ankles, with fingers
securely around other side of client’s body.
5. Lifters roll client toward their chests and on count of
three, client is lifted and held against nurses’ chest.
6. On second count of three, nurses step back and pivot
toward stretcher, moving forward if needed.
Performing Three-person Carry From Bed
to Stretcher
7. Gently lower client onto center of stretcher by
flexing knees and hips until elbows are level with
edge of stretcher.
8. Assess client’s body alignment, place safety straps
across body, and raise side rails.
9. Wash hands.
10. Evaluation:
• Monitor vital signs, ask if client feels fatigued.
• Observe for correct body alignment and
presence of pressure points on skin.
• Note client’s behavioral response to transfer.
• Ask if the client experienced pain during
transfer
TRANSFERRING PATIENTS FROM THE BED TO
A WHEELCHAIR AND BACK TO BED
TRANSFERRING PATIENTS FROM THE BED TO A
WHEELCHAIR AND BACK TO BED
Preparation:
◼ Wash hands
◼ Identify yourself and the patient.
◼ Provide privacy
◼ Explain the procedure.
POSITIONING THE WHEELCHAIR
PARALLEL TO THE BED
1. Place wheelchair at the side of the bed
on the strong side of patient.
2. Lock the wheel brakes and open the
footrests or remove the footrests
closest to the bed.
3. Raise the bed to your waist level or to
high position that enables you to use
good body mechanics.
4. Lower the side rail nearest you.
5. Fanfold the top bed linens down to the
foot of the bed.
6. Ask or assist patient to move towards
you.
7. Assist patient to a sitting position:
◼ Raise the back of the bed to the high
position. Remain at patient’s side to
protect him from a fall.
◼ Ask patient to bend his knees or assist
them to do so.
◼ Grasp the shoulder that is farthest away from
you.
◼ Place your arm under the patient’s knees and
grasp the knee farthest away from you.
◼ Spread your legs about 12 inches apart with one
foot 6-8 inches in back with the other. Flex your
knees.
◼ Swing your body a quarter turn backward and
bring patient’s legs towards you. The patient is
now sitting up.
◼ Place non-slip shoes or slippers on patient’s feet.
◼ Ask the patient to push both fist into the
mattress.
8. Stand in front of the patient and lower the bed to
its lowest position (when controls are located at
the side).
9. Allow patient to rest for a few moments while you
count his pulse.
10. Ask patient to place one arm on each of your
shoulders.
11. Place your arms under patient’s shoulders, reach
around patient’s back, and grasp both of your
wrists.
12. Position your feet apart and lower your pelvic area.
13. Place your knees against patient’s knees.
14. Tell patient to stand on the count of three.
15. On the count of three, rock backward and use
the momentum of your body to bring patient to
a standing position.
16. Ask patient to turn on the foot farthest away
from the wheelchair.
17. Tell the patient to lower an arm to grasp the
side of the wheelchair.
18. Help patient lower himself into the wheelchair.
19. Lift the patient’s legs one at a time, reposition
the footrests, and place the legs on the
footrests.
20. Make patient comfortable and be sure the body
is in good alignment.
Transferring Patients from Bed to Chair and
Back to Bed
Transferring Patients from Bed to Chair
and back to Bed
1. Assist client to sitting position on side of bed. Have
chair in position at 45 degree angle to bed.
2. Apply transfer belt or other transfer aids, if
needed. Client’s arm should be in sling if flaccid
paralysis is present.
3. Ensure client has stable, nonskid shoes. Weight-
bearing or strong leg is placed forward with weak
foot back.
4. Spread feet apart.
5. Flex hips and knees, aligning knees with client’s.
6. Grasp transfer belt from underneath, if used, or
reach, through client’s axillae and place hands on
client’s scapulae.
Transferring Patients from Bed to Chair
and back to Bed
7. Rock client up to standing on count of three while
straightening hips and legs, keeping knees slightly
flexed. Client may be instructed to use hands to
push up if applicable.
8. Maintain stability of client’s weak or paralyzed leg
with knee.
9. Pivot on foot farther from chair.
10. Instruct the client to use armrests on chair for
support and ease into chair.
11. Flex hips and knees while lowering client into
chair.
12. Assess client for proper alignment for sitting
position. Provide support for paralyzed extremities.
Lap board or sling will support flaccid arm.
Stabilize leg with bath blanket or pillow.

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What are the potential hazards of patient transfers?

What safety measures should be taken when using a wheelchair?

TRANSFERRING PATIENTS

 Transferring patients from stretcher to bed

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