BED TO STRETCHER

A transfer can be viewed as the safe movement of a person from one place or surface to another, and as
an opportunity to train an individual to enhance independent function. In both cases the clinician must
choose the most efficient and safest method. Controlling a patient's movement, while moving the
patient from one position, or surface, to another, or preventing a patient falling requires that the
clinician be close to the center of motion (COM) of the patient, which is typically located between the
shoulders and the pelvis. When these points of control are used, patient transfers are more efficient and
patient safety is enhanced. The most efficient way to enhance the movement of the patient (unless he
or she is totally dependent) is to encourage movement of the distal component of the body—the part of
the body that is farthest from the trunk. For example, when assisting a patient to stand from a seated
position, a common verbal cue is to ask the patient to lean his or her trunk forward. In addition, it is also
important to have the patient look in the direction of the transfer's destination to encourage correct
head turning. One of the purposes of transfers is to permit a patient to function in different
environments and to increase the level of independence of the patient. It is important to note that
certain transfers increase the risk for injury, necessitating additional care and attention. Depending on
the functional ability of the patient, a transfer may be performed independently by the patient, with
assistance from the clinician (minimal, moderate, maximal, or standby supervision), or dependently.

Before transferring a client with minimum assistance, inform first the client about desired purpose and
destination. Next, do Hand hygiene.

For the procedure, raise the height of bed to 1 inch higher than the stretcher and lock brakes of bed.
Instruct client to move to side of bed close to stretcher. Lower side rails of bed and stretcher. Leave side
rails on opposite side up. Stand at outer side of stretcher and push it toward bed. Instruct client to move
onto stretcher providing assistance, as needed. Cover client with sheet or bath blanket. Elevate side rails
on stretcher and secure safety belts about client. Release brakes of stretcher. Stand at head of stretcher
to guide it when pushing.

In transferring the client with maximum assistance, inform client about desired purpose and destination.
Hand hygiene. Raise the height of bed to 1 inch higher than the stretcher and lock brakes of bed just like
the first steps in the first procedure. Assess amount of assistance required for transfer. Usually 2 to 4
staff members are required for maximally assisted transfer, it is because the patient’s ability of self-care
is low, moreover, when the patient is weighs more than you, it is important to call for help for you may
give the client a risk for any unwanted injury if you insist that you can. Do not forget to lock wheels of
bed and stretcher and have one nurse stand close to client’s head for support. Logroll client (keep in
straight alignment) and place a lift sheet under client’s back, trunk and upper legs. The lift sheet can
extend under head if client lacks head control abilities. Empty all drainage bags (e.g., T-tube, Hemo Vac,
Jackson-Pratt). Record amounts. Secure drainage system to client’s gown before transfer. Then Move
client to edge of bed near stretcher. Lift client up and over to avoid dragging. Because client is now on
side of bed with side rail down, the nurse on non-stretcher side of bed holds stretcher side of lift sheet
up ( by reaching across the client’s chest) to prevent client from falling onto stretcher or off bed. Place
pillow or slider board to overlap bed and stretcher. Have staff members grasp edges of lift sheet. Be sure
to use good body mechanics. On count of 3, have staff members pull lift sheet and client onto stretcher.
It is essential to count to ensure the unity of lifting the patient and saving the client from any injury.
Position client on stretcher, place pillow under head, and cover with a sheet. Secure safety belts and
elevate side rails of stretcher. Note that If IV pole is present, move it from bed IV pole to stretcher IV
pole after client transfer. And lastly do not forget to wash hands or do hand hygiene.