NRG 301: RELATED LEARNING EXPERIENCE (RLE) ‘

LECTURE 8 WEEK 8 : PATIENT TRANSFER

Frauline Calungsod/ Eddie Dayrit
1st SEMESTER I S.Y 2023

COURSE OUTLINE: MIDTERM

➢ Patient Transfer

MINIMAL ASSIST
➢ Minimal assistance is when
PATIENT TRANSFER the assisting person(s) or
device(s) are required to
A TRANSFER is the safe movement of the patient from one perform approximately 25
place to another, like from bed to wheelchair and by the use percent of the work of a
of assistive devices. In doing so, the nurse must teach the mobility task while the
patient and ask for his or her participation for successful patient performs 75 percent
results. There are many methods of transfer. of the work.
➢ PTA provides assist for
➢ The nurse should choose an appropriate technique about 25% of total patients
for the patient by taking into consideration his or her work. Requires assist for
disabilities and abilities. balance, to move an
➢ In most cases, it is very helpful if the nurse extremity or assistive device.
demonstrates the technique first before the transfer. ➢
During the transfer, the nurse coaches and assists
the patient. MODERATE ASSIST
➢ Moderate assist is a level of assist where the
patient performs about 50 percent of the work
necessary to move and the HCP performs about 50
LEVEL OF TRANSFER percent.
➢ PTA provides assist for about 50% of total patients
work.
Independent The patient consistently performs all
Transfer aspects of the transfer, including setup, in
a safe manner and without assistance

Assisted The patient actively participates, but also

Transfer requires assistance by a clinician(s)

Dependent The patient does not participate actively,

Transfer or only very minimally and the clinician(s)
perform all aspects of the transfer

MAXIMAL ASSIST
LEVEL OF ASSISTANCE ➢ Maximal assistance means
that the HCP performs about
75 percent of the work during
STAND-BY ASSIST (aka SUPERVISION) mobility and the patient
➢ aka SUPERVISION performs 25 percent of the
➢ During stand-by assist, the assisting person does work.
not touch the patient or provide any assistance, but ➢ PTA provides assistance for
needs to be close by for safety in case the patient about 75% of total patient’s
loses their balance or needs help to maintain safety work.
during the task being performed.

CONTACT GUARDING RISK FACTORS RELATED TO PATIENT

➢ With contact guard assist, the HCP needs to merely
have one or two hands on the patient's body but COMMUNICATION
provides no other assistance to perform the ➢ The caregiver must assess the patient’s ability or
functional task. The contact is made to help steady inability to communicate
patient's body or help with ➢ The risk of injury increases if the patient:
balance - Does not speak/understand the same
➢ CLOSE GUARDING language as the caregiver
ASSIST - Does not understand speech
- PTA supervises - Does not understand non-verbal
patient’s work by communication
intermittently - Can not follow simple commands
guiding or - Communicates with sign language or
guarding with assistive communication devices
touch/contact - Has a hearing impairment
- - Has a speech problem

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 - Has a low level of consciousness ➢ Eliminate or minimize risk factors that can lead to
caregiver or patient injury
COGNITION
➢ Often hospitalized patients have an altered level of BEST PRACTICES WHEN USING TRANSFER ASSIST
cognition affecting their ability to participate in DEVICE
lifts/transfers
➢ Short term memory loss, poor judgment, and ➢ Only use transfer assist devices if properly trained in
difficulty making decisions can all be manifestations their safe use. When safe, encourage patients to
of altered cognition. move themselves.
➢ Questions testing the short term memory can often ➢ Tell the patient what you intend to do before you do
give some indication of the level of cognition. it. Ensure that the brakes of the bed, stretcher, or
wheelchair are on before beginning any movement.
MEDICAL STATUS ➢ Inspect each device before use. Tag and remove
➢ Signs and symptoms of various medical conditions damaged equipment from service.
can impact on a patient’s ability to transfer i.e. the ➢ Set the bed at the height of caregivers’ upper thighs.
tremors and movement initiation problems Lower the side rail on the bed to reduce awkward
associated with Parkinson’s disease. reaching
➢ Medications can also affect the patient’s ability to ➢ Minimize gaps and height differences between
transfer. Fatigue, pain and stiffness will affect the surfaces when performing a lateral transfer (for
quality of the transfer. example, from bed to stretcher), and bridge gaps
➢ The medical status can change dramatically during with transfer boards, where necessary.
a shift and caregivers need to observe these ➢ When moving a patient up in bed, tilt the bed to a
changes and modify the lift/transfer as necessary. “head down” position to allow gravity to assist,
unless contraindicated.
PHYSICAL STATUS ➢ Have the patient assist as much as possible during
A PHYSICAL ASSESSMENT SHOULD INCLUDE the transfer or reposition.
➢ Weight-bearing status ➢ Ensure friction-reducing devices are large enough to
➢ Weight be placed under the main points of contact. For
➢ Height supine patients, this includes the pelvis, shoulders
➢ Range of motion (ROM) and, if possible, the feet.
➢ Strength ➢ Avoid lifting the patient.
➢ Balance
➢ Coordination
➢ Sensation DRAW SHEETS/ SLIDE SHEETS
➢ Clothing
➢ Footwear ➢ Draw or slide sheets are made of low friction fabrics
or gel-filled plastics that enable an individual to slide
EMOTIONAL & BEHAVIORAL STATUS over a surface instead of being dragged or lifted.
These sheets come in a variety of widths and
PATIENTS BEHAVIORAL AND EMOTIONAL STATE may
lengths and may be used in pairs, singly, or folded.
change throughout the day i.e. Sundowners. The caregiver
should be aware of behavior changes including:
DRAW SHEETS
➢ Anxiety
➢ Aggression
➢ Agitation
➢ Combativeness
➢ Confusion
➢ Depression
➢ Hostility
➢ Impulsiveness
➢ Low tolerance for change
➢ Self Destructive
➢ Low self esteem (if they think poorly of their abilities ➢
they may not complete the transfer to the level of ➢ Drawsheet has the slippery surface only on one
their ability) side and can be kept under the patient
➢ Rejection
➢ Resistive SLIDE SHEETS

RISK FACTORS RELATED TO EQUIPMENT

➢ Medical devices (catheter bags, IV's, prosthesis)
➢ Inadequate training in the use of equipment
➢ Improper use of equipment or use of faulty
equipment
➢ Risk increases when furniture/equipment not
adjustable
➢
TRANSFER ASSIST DEVICES ➢ A slide sheet, on the other hand, is slippery on both
sides and should be removed once the patient is
➢ Provide a safer means of moving and transferring a repositioned.
person from one place to another.
➢ Facilitate independence and maintain the dignity of
the person being moved or transferred.

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 patients who have been rolled
SLIDER SHEETS
onto their sides
Handles may provide
caregivers with a firm grip
be more appropriate.
If the same sheet is used for
more than one person
infection-control precautions
must be taken.

Not be suitable for some

transfers because they do not
bridge gaps. Where gaps
need to be bridged, caregivers
can use slide sheets in
conjunction with transfer
boards
➢
➢ Slider or roller sheets are tubular sliding sheets
made of specialized fabrics with low-friction inner
TIPS
surfaces that glide over themselves.
➢ Slider sheets may be flat or padded and can be
➢ Use a “palms up” grip when pulling on the slide/roller
placed under draw sheets or incontinence pads.
sheet. A “palms up” grip is a stronger grip than a
Slider sheets come in several sizes and lengths.
“palms down” grip. A “palms up” grip keeps elbows
➢ Short slider sheets are primarily used for pivoting
close to the body and helps to maintain a neutral
and repositioning tasks such as sitting a patient up
shoulder posture.
on the side of the bed or repositioning a patient up
➢ Keep knuckles in contact with the bedsheet to ensure
in bed.
a sliding motion, not a lifting motion
➢ Long lateral slider sheets are intended for
➢ Avoid shrugging the shoulders while moving the
transferring supine patients from one surface to
patient, as this indicates a lifting motion.
another, such as from bed to stretcher.
➢ If repositioning the patient up in bed, tilt the entire bed
with the head down, which allows gravity to assist with
USES: SLIDER SHEETS/DRAW SHEETS
the movement
➢ Ensure that the sheet is taut before moving the patient
to prevent jerking the patient.
➢ Draw sheets can be left under the patient

TRANSFER BELTS
➢ Transfer belts do not reduce the patient’s weight in
any way, and must not be used for lifting patients
➢ Transfer belts come in a variety of sizes and
shapes. They fasten with a buckle, a clasp, or
Velcro, and they usually have handles
➢ Note: Although Velcro fastening is quicker and
easier than using buckles or clasps, the hooks may
get caught on the patient’s clothing and may
deteriorate rapidly if not carefully laundered.

USES ADVANTAGE DISADVANTAGES

➢ Facilitate independent bed mobility
➢ Move patients up in bed During assisted They provide a Belts that are too
➢ Move patients from the side of the bed to the center walking secure grip. wide may affect a
or vice versa patient’s ability to
➢ Turn patients onto their side in bed To guide patients Caregivers do lean forward. Narrow,
Transfer patients from one surface to another, such along transfer not need to grip unpadded belts may
as from a bed to a stretcher (when used in boards during the patient’s dig into the patient’s
conjunction with other devices, such as transfer seated transfers clothing or limbs. waist.
boards)
➢ Move patients who have fallen into confined or Caregivers can Using a belt to lift all
awkward spaces to a place where a mechanical lift guide a falling or most of a patient’s
can be used patient to the body weight is not an
➢ Pivot patients in bed and aid exercise floor. acceptable practice.

ADVANTAGES DISADVANTAGES NOTE: Do not Belts without handles

Simple and versatile
Sliding patients may avoid the
need to manually lift them
Draw sheets may be tucked
part way under seated patients
or completely under lying
use transfer belts encourage the
Sliding patients who have to catch or caregiver to grip the
pressure sores or other support a falling belt with a clenched
sources of sensitivity may patient’s weight. fist. This generally
cause them pain. causes the knuckles
Caregivers can to press into the
Heavy patients may still work in a more patient’s side,
require excessive force to upright posture resulting in
move. And mechanical lift may discomfort.

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 possible to
TIPS: TRANSFER BELTS transfer around Many boards have no
fixed armrests handles for
➢ As long as it is safe to do so, place the transfer belt
positioning or
on the patient with the bed in a raised position to
carrying the board.
avoid awkward bending.
Caregivers must be
➢ Ensure that the belt is fairly snug (you should only
careful not to twist
be able to place two fingers in between the belt and
during the transfer.
the patient) to reduce the chances of the belt sliding
up the patient during the transfer.
Caregivers may still
➢ When performing the transfer, caregivers should
apply horizontal
shift their body weight from one leg to the other and
forces in awkward
perform a gentle pulling motion, using the legs to do
postures.
the work. Avoid lifting during the transfer movement.
➢ Get the patient to assist as much as possible.
Fingers may be
➢ Caregivers should not place their arms through
trapped under board
handles, as pictured. Caregivers would rarely have
edges.
time to free their arms if the patient reacted or fell
suddenly.

SLIDE/ TRANSFER BOARDS

TIPS: TRANSFER BOARDS
➢ Slide/transfer boards or smooth movers are made
of wood or plastic and can be used in conjunction ➢ When transferring a patient between two surfaces,
with roller sheets or slide sheets. Some boards ensure the receiving surface is a little bit lower (no
have rollers, while others have fabric or vinyl more than 2.5 centimetres or one inch) to allow
coverings designed to further reduce friction. gravity to assist. Avoid a difference of more than 2.5
centimetres as this may be too jarring for the patient
➢ Use of a flat sheet directly under the patient will
increase the ease of the transfer because it will
provide the caregivers with something to grasp onto
when pulling the patient onto the bed/stretcher
➢ When applicable, place the receiving surface to the
patient’s stronger side
➢ If the patient is lying on a fitted sheet, do not use
the sheet for the transfer. It’s difficult to keep the
sheet taut during the transfer, and it creates more
➢ Slide/transfer boards are used to reduce friction and friction with the slide/transfer board, thereby
bridge gaps when sliding patients between two increasing the force required by the caregiver.
horizontal surfaces such as from a bed to a
stretcher.
➢ Others involve pushing the patient or pulling a draw ASSESSMENT
sheet across the transfer board. Prior to lifting any object or materials, an assessment of the
➢ These boards are suitable only for those patients most appropriate method of lifting should be completed. Plan
who can power themselves by sliding or rolling the lift in your mind - organize the lift so that it will be best for
along the board with guidance from a you and your co-workers.
knowledgeable caregiver. Some procedures require ➢ If you are uncertain about your ability to lift an
the caregiver to push or pull the board to object safely, get help! Never “go it alone.” Try the
accomplish the transfer. heft test. Get an idea if you can manage the lift.
➢ Always consider proper positioning of the spine and
USES ADVANTAGE DISADVANTAGES upper extremity to prevent injury.
➢ If you have an idea how the lift or environment
Slide/transfer Caregivers do Inappropriate use (for could be improved, talk to your manager. Taking a
boards can be used not need to lift example, with few seconds to consciously prepare for the lift may
to bridge gaps manually patients who cannot prevent you or a co-worker from days, months or
between two offer sufficient years of pain.
surfaces to facilitate Some patients assistance) may put
patient transfer, may be able to caregivers at a high ASSESSMENT BEFORE STARTING A LIFT OR
such as between: transfer risk of MS TRANSFER ESSENTIAL
themselves, A good assessment includes:
Bed & wheelchair avoiding the Some slide/transfer ➢ Ensures that the transfer/lift is appropriate for the
Wheelchair & toilet need for boards do not caregiver and patient
Chair & wheelchair caregivers to sufficiently reduce ➢ Aids in preventing back and shoulder strain/injury to
Wheelchair & car perform certain friction. the caregiver
Rolling slide boards transfers ➢ Reduces the risk to the patient and/or caregiver
can be used when Two equal-height
transferring supine Boards are surfaces are needed An appropriate transfer/lift:
patients between available in a for easy transfer. For ➢ Is safe for the caregiver and patient
bed and stretcher. range of seated transfers, ➢ Enables the patient to be as independent as
widths, lengths, patients must have possible
and curves, some degree of ➢ Is comfortable for the patient
making it sitting balance. ➢ Provides the least wear and tear on the back and
shoulders of the caregiver

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WHY IS CONSISTENCY IMPORTANT?
➢ Unexpected incidences or lack of patient
cooperation are often contributing factors in injuries
to caregivers.
➢ When the lifting technique is consistent the patient
is more likely to cooperate and be less anxious.
WHO SHOULD DO THE ASSESSMENT?
➢ The nurse is responsible for assessing the patient's
transfer/lift needs.
➢ Physiotherapists and/or Occupational Therapists
are available for consultation concerning complex
cases. A referral may be required if intervention to
improve transfers is indicated
WHEN SHOULD THE INITIAL ASSESSMENT BE DONE?
➢ The admitting nurse should do the assessment of
the most appropriate lift/transfer at the time of
admission.
➢ The accepted lift/transfer should be noted on the
admission history and the Kardex
WHAT SHOULD BE INCLUDED IN THE INITIAL
ASSESSMENT?
➢ Caregiver status
➢ Assess the patient’s abilities (strength, ROM,
balance, etc.)
➢ The environment
➢ Equipment available
WHEN ARE LIFTS/TRANSFER REASSESSED?
➢ Reassessment is important because a patient’s
ability to assist and cooperate may vary from day to
day, or even at different times during the same day
because of medication, fatigue, stress or pain
➢ Reassessment may help to prevent those
unexpected incidents
➢ More formal reassessments are necessary when a
patient’s condition improves or deteriorates. This
ensure the procedure listed on the kardex is most
appropriate
➢ Reassessment also helps to maintain a high level of
awareness about patient handling
WHAT NEEDS TO BE REASSESSED?
➢ Change in medical status
➢ Patients ability to communicate
➢ Level of cognition
➢ Level of aggression
➢ Physical Abilities (ROM, strength)
➢ Environment
➢ Availability of Equipment
➢ Caregiver Ability
FACTORS TO CONSIDER WHEN ASSESSING PATIENT
HANDLING TASK
PREPARATION
Prepare the Equipment
➢ Adjust position of the equipment (bed, stretcher,
wheelchair, etc)
➢ Adjustments to the chair include locking brakes,
checking cushion position (if available), removing
arm rests if necessary for transfer/lift, positioning
chair at appropriate angle.
➢ Adjustments to the bed include locking brakes,
putting downside rails, adjusting bed height (hip
height if standing, mid thigh height if knee on bed,
level with chair if using sliding board or hemi
transfer)
➢ Adjust position of the equipment (bed, stretcher,
wheelchair, etc)
➢ Ensure all devices are in good working order
including belts, lifts, slings
Prepare the Patient
➢ Explain what you are about to do with the patient. A
well-prepared patient can make your workload
easier!
➢ Ensure the patient places their hands on the
appropriate place to assist with the lift i.e. the side
rail. DO NOT ALLOW THE PATIENT TO GRAB
AROUND THE CAREGIVERS NECK. This could
lead to neck injury or strain.
➢ Position the IV tubing/poles, catheter bags and
other appliances so that they do not interfere with
the transfer
➢ Maintain the patient’s dignity
Prepare the Caregiver
➢ Complete a brief reassessment to ensure
appropriate lif
➢ Position the caregiver so the patient feels safe, the
patient can hear and see the caregiver, and with
appropriate body mechanics (the feet apart and
knees bent slightly)
➢ Discuss the plan with lifting partners
➢ Explain the plan to the patient including their role in
the transfer/lift
➢ Use simple instructions/one step commands
➢ Tighten abdominal muscles (core) before you lift.
Maintain normal spinal alignment by keeping a
slight inward curve just above the pelvis. Use the
powerful leg muscles to help with the handling
procedure
➢ Use both hands and hold the patient as close to
your body as possible. Never grasp the patient
under the arms. This can lead to injury or
subluxation
➢ Count with lifting partners so everyone moves at the
same time “1 ,2, 3, lift!”
➢ Be prepared for the unexpected
➢ If the load starts to slip or the patient starts to fall,
go with it. Try not to rotate. Protect the patient’s
head
➢ If the patient falls assess their condition before
returning them to bed
➢ Postpone the lift/transfer if the patient is resistive,
uncooperative or aggressive (if non emergent)
Prepare the Environment
➢ Clear a working area
➢ Eliminate any obstacles
➢ Ensure adequate lighting
➢ Dry floor
➢ Minimize distracting noises
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 ➢ Prepare the patient: Ensure the patient’s clothes
THE PRINCIPLES OF SAFER PATIENT HANDLING
and footwear are appropriate for the task, and they
have any aids they need. Adjust their clothes, aids
Before the task and position – for instance, encourage the patient to
➢ Wear the right clothes: Make sure your clothing and lean forward
footwear are appropriate – clothes should allow free ➢ Give precise instructions: The lead carer directs the
movement and shoes should be non slip, supportive move and gives clear instructions, eg. “Ready,
and stable steady, stand”. This helps carer/s and patient work
➢ Never lift: Never plan to lift manually – always use a together.
hoist to lift a patient
➢ Know your limits: Know your own capabilities and
THE PRINCIPLES OF SAFER PATIENT HANDLING
don’t exceed them – for instance, if you need
training in the technique to be used, tell your
manager After the task
➢ Do one thing at a time: Don’t try to do two things at ➢ Correct your posture: Stand up straight to correct
once – for instance, don’t try to adjust the patient’s your spinal alignment. Hold your chest open,
clothing during the transfer shoulders back and abdominal muscles in so your
➢ Prepare for the task: Make sure everything is ready lower body aligns properly with your upper body
before you start – for instance, check other carers ➢ Re-evaluate the task: Could the task have been
are available if needed, equipment is ready and the done better? How? Mark the patient profile with
handling environment is prepared your comments
➢ Choose a lead carer: The lead carer checks the ➢ Report any issues: If you identify issues that affect
patient profile and co-ordinates the move. You patient handling, report them to your manager and
should also try to match the height of add them to the workplace control plan for action.
➢ Apply safe principles: Always use safe
biomechanical principles – and use rhythm and
MOVING PATIENTS FROM BED TO WHEELCHAIR
timing to aid the task
➢ Caution – High risk. The patient shouldn’t hold on to
you or your clothing, because it is diffi cult for you to Stand the Patient Up
disengage and the patient could pull you off ➢ Have the patient scoot to
balance. It is unsafe for carers and patients the edge of the bed.
➢ Put your arms around the
SAFE BIOMECHANICAL PRINCIPLES patient’s chest and clasp
your hands behind his or
➢ STAND IN A STABLE POSITION: Your feet should be her back. Or, you may also
shoulder distance apart, with one leg slightly forward use a transfer belt to
to help you balance – you may need to move your feet provide a firm handhold.
to maintain a stable posture ➢ Support the leg farthest
➢ AVOID TWISTING: Make sure your shoulders and from the wheelchair
pelvis stay in line with each other between your legs, lean
➢ BEND YOUR KNEES: Bend your knees slightly, but back, shift your weight,
maintain your natural spinal curve – avoid stooping by and lift.
bending slightly at the hips (bottom out)
➢ ELBOWS IN: Keep your elbows tucked in and avoid Pivot Toward Chair
reaching – the further away from the body the load is, ➢ Have the patient pivot
the greater the potential for harm toward the chair, as you
➢ Tighten abdominal muscles: Tighten your abdominal continue to clasp your
muscles to support your spine hands around the patient.
➢ Head up: Keep your head raised, with your chin ➢ A helper can support the wheelchair or patient from
tucked in during the movement behind.

Sit the Patient Down

THE PRINCIPLES OF SAFER PATIENT HANDLING
Carrying out the task
➢ Check patient profile: Decide if the task is still
necessary and that the handling plan is still
appropriate. Check it still matches the clinical
pathway and physician’s orders
➢ Seek advice: Talk to your manager or the patient
handling adviser if you need advice on the
techniques and equipment you should be using
➢ Check equipment: Ensure equipment is available in
good order with all components in place and ready
to use (eg. batteries charged). Always follow the
manufacturer’s instructions
➢ Prepare handling environment: Position furniture
correctly, check route and access ways are clear,
and check the destination is available
➢ Explain the task: Explain the task to the patient and
other carers who will be helping
➢ As the patient bends toward you, bend your knees
and lower the patient into the back of the
wheelchair.
➢ A helper may position the patient’s buttocks and
support the chair
PULLING A PATIENT UP IN BED
Grasp the Draw Sheet
➢ Put the head of the bed down and adjust the top of
the bed to waist or hip level of the shorter person.
➢ Grasp the drawsheet, pointing one foot in the
direction you’re moving the patient
➢ Lean in the direction of the move, using your legs
and body weight.
➢ On the count of three, lift and pull the patient up.
Repeat this step as many times as needed to
position the patient.

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 ➢ Also, patients can bend
➢ Instruct patient to cross arms across chest and
their knees, push down
explain move to patient.
with their feet, and pull
2. Pull to Edge of Bed
up with a trapeze (a
➢ Grasp the draw-sheet on both sides of the bed.
device overhead) to
➢ On the count of three, lean back and shift your weight,
help Remember: Putting
sliding the patient to the edge of the bed. The helper
a pillow under your
holds the sheet, keeping it from slipping
patients’ feet helps
3. Position Stretcher
them push down,
making it easier for you
➢ Have the helper
to pull them up. Never
“cradle” the
clasp the underarm to
patient in the
move the patient. This
draw-sheet while
may cause injury to the
you retrieve a
shoulder (i.e.,
stretcher.
dislocation).
➢ Adjust the bed to
➢
be slightly higher
than the stretcher.
Then, position the
stretcher, locking it
TURNING PATIENTS OVER IN BED in place.
➢ Move the
patient’s legs onto
Cross Arms the stretcher.
➢ Put the bed 4. Slide Onto
rail and head Stretcher
of the bed ➢ Have the helper
down; adjust kneel on the bed, holding on to the draw-sheet.
the top of the ➢ On the count of three, grasp the draw-sheet and slide
bed to waist- the patient onto the stretcher. You may need to repeat
or hip-level. this step.
➢ Cross the
patient’s
arms on his
or her chest; TRANSFERRING USING A TRANSFER BOARD
bend the leg
farther away ➢ Place the wheelchair as close to the bed as
from you possible, and
position it at
Turn the Patient about a
➢ Put one 30-degree
hand behind angle with the
the patient’s bed
far shoulder. ➢ Lock the
➢ Put your other hand behind the patient’s hip brakes on the
➢ Turn the patient, supporting the patient’s leg with wheelchair,
your knee move the
➢ Remember: Putting one knee on the bed gets you footrests out of
closer to the patient, so you pull more with you. the way, and
➢ remove the
armrest on the
side closest to
MOVING PATIENTS FROM BED TO STRETCHER
the patient.
(GURNEY)
➢ Help the patient to sit on the edge of the bed with
his feet flat on the floor.
Patient safety is often the main concern when moving patients
➢ Help the patient to lean over slightly away from the
from bed. But remember not to lift at the expense of your own
wheelchair, and carefully slide one end of the
back. And, never move a patient by yourself. Two people
transfer board under the thigh that is closest to the
usually can do this move safely. The leader, who pulls, should
wheelchair. Point the end of the board down into the
be the stronger of the two. The helper holds the draw-sheet,
bed as you do this, to avoid pinching the patient's
neither pushing nor lifting
skin.
➢ Place the other end of the transfer board flat on the
Remember: If you move the patient's legs first, you can
seat of the wheelchair
decrease the stress on your back by as much as a third.
with the end of the board
pointed at the back seat
The leader should have one foot forward with knees bent.
corner farthest from the
1. Prepare to Move
bed. (A caregiver may use
➢ Put the head of the bed down and adjust the bed
a gait belt to help you
height.
move across the transfer
➢ Put a garbage bag or plastic slide board between the
board.)
sheet and draw-sheet, beneath one edge of the
➢ Assist the patient with
patient’s torso.
several short "scooting"
➢ Move the patient’s legs closer to the edge of the bed.
motions onto the board. If

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 the board is on the patient's left, have him lean his
upper body slightly to the right before each scooting
motion. The patient can place his hands on the bed
and rest some of his weight on his hands to make it
easier to move onto the board.
➢ Make sure the patient doesn't fall as he moves
across the board in several small movements, until
he is seated on the wheelchair
➢ Remove the board, replace the armrest, and
position the footrests.

TRANSFER: WHEELCHAIR TO CHAIR

➢ Patients who cannot walk are taught to use
wheelchairs. For
safety, have the
therapist show
you the correct
way to help
someone out of
a wheelchair.
Start by locking
the wheels of
the chair. Then
stand as close
to the patient as
you can. Make
sure your
footing is stable.
The patient
should always wear a
special belt for you to
grip
➢ Help the person scoot
to the edge of the chair.
Be sure the patient’s
feet are under his or her
body. Lift as the person
pushes up.
➢ Keep the person’s
weaker knee between
your legs. Pivot the
person around in front
of the toilet or chair.
Lower him or her gently.

TRANSFER: WHEELCHAIR TO TOILET

Stand the patient up
➢ Lock the wheelchair.
➢ Be sure the person’s
feet are under his or
her body.
➢ Grasp the back of a
belt or pants and lift.
➢

Move on the toilet

➢ Keep the person’s
weaker knee between your
legs.
➢ Pivot the person around in
front of the toilet. Always
transfer toward the
person’s stronger side.
➢ Gently sit the patient down
onto the toilet.
➢ Help the patient adjust
their clothing.
➢ Never pull on the person’s
weaker arm or lift the person by the armpits

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