alth care Iacilities moving patient Irom one place to another is a common activity.

Patient is
transIerred Irom bed to chair, chair to commode or wheelchair to tub. Once the physician
permitted the patient out oI bed, transIer activities are started. However, beIore doing so, it is
essential that the nurse assesses the patient`s ability to participate in the transIer.
Preparing the Patient for Transfer
Maintaining muscle strength and participation in 'push-up exercises while conIined to bed is
important Ior the patient to perIorm to strengthen the arm and extensor muscles oI the shoulder.
In doing the push-up exercise, the patient should be instructed to sit upright in bed and a book is
placed under each oI the patient`s hands to provide a hard surIace. The nurse then instructs the
patient to push down the book while raising the body. It is essential that the patient raise and
move the body in diIIerent directions by means oI this technique.
Patient Transfer
A transIer is the movement oI the patient Irom one place to another. In doing so, the nurse must
teach patient and ask Ior his or her participation Ior successIul results. There are many methods
oI transIer. The nurse should choose an appropriate technique Ior the patient by taking into
considerations his or her disabilities and abilities. In most cases, it is very helpIul iI the nurse
demonstrates the technique Iirst beIore the transIer. During the transIer, the nurse coaches and
assists the patient.
Primary Concern during Transfers
During a transIer the nurse`s primary concern is patient saIety. This is demonstrated by keeping
the Iollowing things in mind:
S Sliding boards are used to bridge the gap between the bed and the chair iI the patient`s
muscles are not strong enough to overcome the resistance oI body weight. TransIer or movement
devices may be used in cases where mechanical devices are not available, additional personnel is
needed Ior large patients.
A Ascertain that chairs and beds are locked beIore the patient transIers. Potential hazards
associated with transIerring patients should be identiIied by the nurse and establishment oI saIe
practices is essential.
F Frequent assessment oI patient needs by a registered nurse beIore transIer to determine
patient`s ability to participate during the transIer and use necessary skill appropriate Ior this
patient.
E Ensure that one staII member remains with the patient during the transIer.
Transfer from Bed to Stretcher
One oI the most common transIers is moving a patient Irom the bed to the stretcher. The number
oI personnel required to make the transIer possible and successIul depends on the size oI the
patient and the physical abilities oI the primary nurses. Thus, this technique requires the help oI
either one or more personnel. The Iollowing are included to achieve this transIer method:
O Straight liIt
O arry liIt
O iIt sheet transIer
O Sliding board transIer
FOUR-PERSON STRAIGHT LIFT
This technique is also termed as patient-assisted liIt and is used when moving a child, a very
light patient or a patient who have the ability to assist and participate during the transIer.
1. InIorm the patient that you are going to move him Irom the bed to the stretcher.
2. Place the patient in a supine position.
3. Ask the team members to remove watches and rings beIore the transIer. This is to avoid
scratching the patient during the transIer.
4. Position the stretcher parallel to patient`s bed. Make sure that the wheels oI bed and
stretcher are lock to ensure patient saIety.
5. Raise bed to a comIortable working height.
6. Have one team member stand at the center oI the stretcher and another staII at the
patient`s head. The remaining two members should stand next to bed on the other side
and at the center oI the patient`s Ieet.
7. With palms Iacing up, slide arms beneath the patient to support patient`s buttocks and
hips. The member standing at the head should support patient`s shoulders and head while
the one at the Ioot supports the legs and Ieet.
8. iIt the patient several inches on the count oI three and move him or her to the stretcher.
The team member`s arms should slide their arms out Irom under the patient. Smooth
movements must be maintained during the transIer to minimize patient discomIort and
avoid muscle strain by team members.
FOUR-PERSON CARRY LIFT
1. InIorm the patient that you are going to move him Irom the bed to the stretcher.
2. Place the patient in a supine position.
3. Ask the team members to remove watches and rings beIore the transIer. This is to avoid
scratching the patient during the transIer.
4. Position the stretcher perpendicular to the bed with the head oI stretcher at the Ioot oI the
bed. Bed and stretcher wheels should be locked to prevent patient injury.
5. Raise bed to a comIortable working height.
6. All Iour members oI the team should line up on the same side oI the bed. The tallest staII
should stand at the patient`s head while the shortest is at the patient`s Ieet. iIt signals are
given by the leader who is the member positioned at the head oI the patient.
7. The leader instructs his members to Ilex their knees and with palms Iacing up, their hands
should slide under the patient until he or she rests securely on their upper arms.
8. Make sure that the patient is properly and adequately supported especially at the head and
shoulders hips and buttocks and legs and Ieet.
9. Straighten knees on the count oI three and roll the patient on his side against the team
member`s chest.
10.The team members step back together with the staII supporting the Ieet moving the
Iarthest. Move Iorward to the stretcher`s edge together and on the count oI three lower
the patient to the stretcher by bending the team member`s knees and sliding their arms
out Irom under the patient.
FOUR-PERSON LIFT SHEET TRANSFER
1. InIorm the patient that you are going to move him Irom the bed to the stretcher.
2. Place the patient in a supine position.
3. Ask the team members to remove watches and rings beIore the transIer. This is to avoid
scratching the patient during the transIer.
4. Position the stretcher parallel to patient`s bed. Make sure that the wheels oI bed and
stretcher are lock to ensure patient saIety.
5. Raise bed to a comIortable working height.
6. Have one team member stand at the center oI the stretcher and another staII at the
patient`s head. The remaining two members should stand next to bed on the other side
and at the center oI the patient`s Ieet.
7. Hold the edges oI the sheet under the patient, grasping them close to him or her. This is to
obtain a Iirm grip, provide stability and spare the patient undue Ieelings oI instability.
8. iIt or slide the patient to the stretcher in a smooth continuous motion on a count oI three
to avoid muscle strain and minimize patient discomIort.
SLIDING BOARD TRANSFER
1. InIorm the patient that you are going to move him Irom the bed to the stretcher.
2. Place the patient in a supine position.
3. Ask the team members to remove watches and rings beIore the transIer. This is to avoid
scratching the patient during the transIer.
4. Position the stretcher parallel to patient`s bed. Make sure that the wheels oI bed and
stretcher are lock to ensure patient saIety.
5. Raise bed to a comIortable working height.
6. Stand next to the bed and instruct a coworker to stand next to the stretcher.
7. Turn the patient slightly on his side. To do this, reach over the patient and pull the Iar
side oI the bed sheet toward you.
8. The coworker places the sliding board beneath the patient and makes sure that the board
bridges the gap between the stretcher and the bed.
9. Gently ease the patient to the sliding board and release the bed sheet. The staII or
coworker then grasps the near side oI the sheet at the hips and shoulders oI the patient.
Slowly pull the patient onto the stretcher in a smooth and continuous motion.
10.Reach over the patient and grasp the Iar side oI the sheet and logroll him or her towards
you.
11.Remove the sliding board as the coworker returns the patient to a supine position.
Things to do aIter the transIer:
O Position the patient comIortably.
O Apply saIety straps.
O Secure the side rails.
Transfer from Bed to Wheelchair
TransIerring a patient Irom bed to wheelchair may need partial support to Iull assistance initially
by at least two health care personnel. For subsequent transIer oI a patient with generalized
weakness, one nurse may be required Ior the perIormance oI the technique.
1. Explain the procedure to the patient and demonstrate his role during the transIer to gain
cooperation.
2. Position the wheelchair parallel to the bed and make sure that both wheels are locked.
Bed wheels should also be locked. To avoid interIering with the transIer make sure that
the Iootrests are raised.
3. Pulse rate and blood pressure should be checked while the client is in a supine position to
obtain a baseline data.
4. Assist the patient in putting on the pajama bottoms and slippers or shoes with non-slip
soles to prevent Ialls.
5. Raise the head oI bed and allow the patient to rest brieIly. Giving time Ior the patient to
rest allows him top adjust to changes in posture and position.
6. Bring the patient in a dangling position.
7. Recheck the patient`s pulse rate and blood pressure is cardiovascular instability is
suspected. II PR and BP are unstable do not proceed with the transIer to prevent Ialls.
8. Ask the patient to move towards the edge oI the bed and to place his or her Ieet Ilat on the
Iloor.
9. Stand in Iront oI the patient and block his toes with your Ieet and his knees with yours to
prevent his or her knees Irom buckling.
10.Slightly Ilex your knees and place your arms around the patient`s back above the waist
but below the level oI the axilla. Instruct the patient to place his or her hands on the edge
oI the bed.
11.Ask the patient to push himselI oII the bed and to support much oI his or her weight as
much as possible. While doing this, straighten up your knees and hips to raise the patient
as you straighten your body.
12.Pivot the patient toward the wheelchair while supporting him or her as needed. Make sure
that you keep your knees next to the patient.
13.Ask the patient to grasp the Iarthest armrest oI the wheelchair with his closest hand.
14.To help the patient lower him or herselI into the wheelchair, Ilex you knees and hips (not
on your back) and instruct him or her to reach back and grasp the other wheelchair
armrest as he sits to avoid abrupt contact with the seat. To prevent Ialls Iasten the seat
belt.
15.II necessary, check the patient`s pulse rate and blood pressure to assess cardiovascular
stability. II the patient`s PR is 20 beats more above the baseline, it is imperative to stay
with the patient and closely monitor him until it returns to normal. Patients having this
pulse rate aIter transIer are experiencing orthostatic hypotension.
16.Help the patient position him or herselI correctly in the wheelchair by moving his or her
buttocks against the back oI the chair.
17.Place the patient`s Ieet on the Iootrests pointed straight ahead. II appropriate, using
elevating leg rests to Ilex the patient`s hips at more than 90 degrees may be done to
relieve pressure on the popliteal space and places more weight on the ischial tuberosities.
18.Place patient`s arms on the wheelchair armrests with the shoulders abducted, elbows
slightly Ilexed, Iorearms pronated and wrists and hands in the neutral position. To
prevent dependent edema, you may support or elevate the hands and Iorearms oI the
patient with a pillow.