Presented by:M. Sivanandha Reddy

Definition of transferring

Transferring refers to moving a patient from bed to a chair or to a stretcher, or to a wheelchair with maximum comfort and safety for patient and nurse.

Reasons for transferring

Improvement of the patient’s condition (from ICU to medicine unit .

Worsens of patient’s condition ( to ICU)

The need for surgery or X ray Transfers at the patient’s request For any other diagnostic tests.

Reasons for moving

Change positionRepositioning the client Client’s slid down in bed from fowler’s position

Changing the bed linen

Methods of transferring By wheel chair By stretcher By a movable bed

Assess: The client’s physical abilities Ability to understand instructions Degree of comfort or discomfort when moving

Client’s weight Presence of orthostatic hypotension Your own strength and ability to move the client

If indicated, use pain relief modalities or medication prior to moving the client

Prepare supportive equipment (pillows) Obtain required assistance Explain the procedure to the client and

listen to any suggestions the client

Provide privacy

Wash hands Raise the height of the bed to bring

the client close to your center of gravity

Lock the wheels on the bed and raise the rail on the side of the bed opposite you to ensure client safety

Face in the direction of the movement to prevent spinal twisting

Transferring the patient from bed to wheel chair:

1 .Review the medical record and nursing plan of care for conditions that may influence the

patient’s ability to move or to be positioned2 .Perform hand hygiene and put on PPE, as

indicated. Identify the patient. Explain the procedure to the patient

3 .Provide privacy4 .Raise the head of the bed to a sitting

position

5 .Make sure the bed brakes are locked. Put the chair next to the bed. If available, lock the brakes of the chair. If the chair does not have brakes, brace the chair against a secure object

6 .Lower the side rail, if necessary, and stand near the patient’s hips. Stand with your legs shoulder width apart with one foot near the head of the bed, slightly in front of the other foot

7 .Assist the patient to sit up on the side of the bed

Transferring the patient from bed to wheel chair:

8 .Wrap the gait belt around the patient’s waist, based on assessed need and facility policy

9 .Stand facing the patient. Spread your feet about shoulder width apart and flex your hips and knees

10 .Ask the patient to slide his or her buttocks to the edge of the bed until the feet touch the floor .

11.Position yourself as close as possible to the patient, with your foot positioned on the out side of the patient’s foot

Transferring the patient from bed to wheel chair:

12 .Using the gait belt, assist the patient to standRock back and forth while counting to three. On the count of three, use your legs (not your back) to help raise the patient to a standing position . If indicated, brace your front knee against the

patient’s weak extremity as he or she stands

13 .Pivot on your back foot and assist the patient to turn until the patient feels the chair against his or her legs.

Transferring the patient from bed to wheel chair:

14 .Ask the patient to use an arm to steady him- or herself on the arm of the chair while slowly lowering to a sitting position . Continue to brace the patient’s knees with your knees and hold the gait belt. Flex your hips and knees when helping the patient sit in the chair.

15 .Assess the patient’s alignment in the chair. Remove gait belt , if desired. Depending on patient comfort, it could be left in place to use when returning to bed. Cover with a blanket, if needed.

Transferring the patient from bed to wheel chair:

Transferring the patient from bed to stretcher and from the stretcher to the bed is done to patients who cant help themselves and need help.

The selection of transfer technique is individualized.The following methods can be used.

1 .Draw sheet method2 .Patient is lifted by three persons

3 .Mechanical devices like hydro ureter lift

Lower the head of the bed until it is flat.

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 draw sheet out from both sides of the bed.

Place the stretcher parallel to the bed.

Four nurses or helpers are required.

One stands at the opposite side of the bed. Remaining three stands across the stretcher one supporting the head and shoulders, second one supporting the hips and thighs and the third one supporting the feet and legs.

1 .Grasp the draw sheet tightly2 .Co-ordinate lifting by counting the

numbers of 1, 2, 3 and receive the patient in stretcher by pulling the draw sheet and the patient towards the stretcher, quickly and gently.

3 .The sheet can be removed by turning the patient from side to side.

Three persons lifting the patient1 .Three people, all standing on the same side of

the patient, slip their hands, palms facing up, beneath the patient.

2 .First person holds the head and shoulder, second person holds the trunk upto thigh and the third person holds the legs.

3 .Cradle the patients in the arms so that the patients weight rests against the nurses chests and the patient faces nurses.

Three persons lifting the patient

4 .Care must be taken so that the patient will not be dropped down suddenly.

5 .The nurses should bend over and release the weight of the patient gradually and until it rests gently upon the bed or stretcher.

Moving the client up in bed1 .Review the medical record and nursing plan of

care for conditions that may influence the patient’s ability to move or to be positioned .

2 .Assess for tubes, IV lines, incisions, or equipment that may alter the positioning procedure. Identify any movement limitations .

3 .Consult patient handling algorithm for moving the patient.

5 .Perform hand hygiene and put on PPE6 .Identify the patient. Explain the procedure to

the Patient

7 .Close curtains around bed and close the door

to the room, if possible8 .Adjust the head of the bed to a flat position

9 .Remove all pillows from under the patient. Leave one at then head of the bed, leaning upright against the headboard.

Moving the client up in bed

9 .Position at least one nurse on either side of the bed, and lower both side rails

10 .Ask the patient (if able) to bend his or her legs and put his or her feet flat on the bed to assist with the movement.

11 .One nurse should be positioned on each side of the bed

12 .Grasp the friction-reducing sheet securely, close to the patient’s body

Moving the client up in bed

13 .Flex your knees and hips. Tighten your abdominal and gluteal muscles and keep your back straight

14 .On the count of three, move the patient up in bed

15 .Assist the patient to a comfortable position and readjust the pillows and supports, as needed. Return bed surface to normal setting

Moving the client up in bed