Transfer Tips Guidebook

Safe Transfers:
Assisting Patients with Disabilities

Introduction
Some individuals need assistance getting on and off exam

tables, even when using tables that lower to 17 - 19 inches
from the floor. Providers always should ask patients if
they need help, the best way to go about it, and what extra
equipment, if any, is needed.
Some people will need a lot of assistance, some will need
only a steady hand, and others will find it safer and easier
to transfer without assistance.
If patients are new to their disability or have a cognitive
impairment, they may not be able to offer information
about the best way to assist them. In these cases, check
with the people who are with them, if present. Others
will need assistance with tools such as a transfer sheet
or board — a smooth, rigid material that bridges two
surfaces over which the patient slides (See pg. 10 for details).
Contents:
Safety Overview .............................................................. 3
Basic Transfer Techniques
Prepare the Patient ..................................................... 4
Organize the Environment for Ease and Safety ........ 4
Prepare the Equipment .............................................. 4
Prepare Yourself ......................................................... 5
Tips for Typical Transfers ............................................. 6
Using Lift Equipment/Assisted Transfers ........... 8-10
SPHM Solutions ...........................................................11
2
Safety Overview
Using the proper method for transferring individual

patients is important for keeping them safe and
preventing worker injuries.
Transfers That Cause Injuries:
• Repositioning patients
• Transferring patients from table to wheelchair,
walker, or toilet
• Supporting weight of semi-ambulatory individuals
Why So Many Injuries Occur:
• Healthcare workers often put patient comfort
above their own to get the job done
• Longer shifts and fewer staff means
more lifts with less help (e.g., working
nurses restricted from lifting)
• Lack of proper Safe Patient
Handling and Mobility (SPHM)
lift equipment, teams,
or training
• People can be heavy
(e.g., a person’s leg alone
can exceed a health worker’s
recommended 35-pound
lift limit)
• Unpredictable
movements can prompt
poor lift postures
3
Basic Transfer Techniques
Prepare the Patient:

• Never assume individuals need help. Ask always,
“How can I best assist you?” Listen carefully and
incorporate what they tell you.
• Determine individuals’ mobility and how much they
can help by asking if they need assistance.
• Explain what’s going to happen during the transfer.
• Use clear instructions “Lean forward,” “Lift,”
and “Swing.”
Organize the Environment for Ease and Safety:
• Remove all possible obstructions from equipment or
path of movement.
• Secure all necessary equipment, supplies, or get
assistance before the transfer so you don’t have to
leave the individual that you’re attending.
• Keep all surfaces as level as possible.
Prepare the Equipment:
• Raise or lower the exam table to maximize leverage.
• Lock brakes on all devices.
• If needed, remove wheelchair arm and leg rests, fold
up foot plates, and put parts in one place.
• If applicable, align wheelchair or mobility device on
the person’s strong side.
• Position equipment to create the smallest angles and
shortest travel distance.
• Push chairs (non-wheelchair) against the wall to
prevent sliding.
4
C
B
A
Prepare Yourself:
A Maintain a Good Base of Support: Keep your
feet apart (one foot slightly forward), to strengthen
your stance and center of gravity.
B Never Reach or Stoop: Point your feet in the
direction of the weight and always keep it as close
to you as possible.
C Keep Your Back Straight: Bend with your knees,
not from your waist; pull your stomach in and lift
your chin.
D Don’t Lock Your Joints: Keep your weight
forward and knees flexed to absorb shock.
5
Tips for Typical Transfers
Here’s a checklist for two common types of transfers.

1. Helping individuals sit up for repositioning:
Ask always, “How can I best assist you?”
When they know, listen carefully and incorporate
what they tell you.
Explain to individuals that you are going to
reposition them. Raise or lower the table
(if applicable) to optimal working level.
Help them sit up.
2. Transferring people from exam table to wheelchair:
Ask always, “How can I best assist you?”
Adjust table height to maximize ease of transfer.
Lock brakes.
Explain to individuals that you’re going to help
them into a standing position.
Ask individuals to place their hands on your arms
or shoulders as if you were a walker.
Block individuals’ lower extremities with your feet
(toes pointing slightly outward) to prevent slipping.
Pivot toward the chair and ease person into it.
6
How can I best
assist you?
7
Tips for Using Lift Equipment
Some people require total lift assistance and, because of

their size, lift equipment may be needed. There are many
different types of lifts available.
Assisted Transfer – with a Portable Floor Lift
1 Clearance beneath the exam table and an angled
approach of the lift allows the patient to be positioned
directly over the exam table for a safe transfer.
2 Ensure the individual is safe and able to maintain

their balance on the exam table. If needed, help to
position the individual on the table. Check by asking
“Are you safe on the table or should I wait with you
until the doctor arrives?”
3 Do not leave people unattended if there is any chance

that they may not be safe on the table.
4 Record what worked for the patient in their record.

Refer to these notes before the appointment, and
always check with the patient to make sure the
information is still correct.
8
Portable Floor Lifts
A common lift is one with wheels on a U-shaped base
that fits around the bottom end of an exam table, or fully
or partially under it at a perpendicular angle. Some lifts
require only one operator; others are more easily operated
by two or more people. An advantage of portable floor
lifts is they can be moved from room to room for use with
multiple exam tables — provided procedures for sharing
and storage are in place to prevent scheduling conflicts.
9
While portable lifts are less expensive than overhead ones,
they require more space for both in-room maneuvering
and storage.
Medical staffs will likely need training on equipment

operation and safe patient handling techniques to ensure
transfers are done properly.
Notes about Portable Floor Lifts:

• The amount of floor space needed to maneuver will
depend on the type of floor lift equipment used
• Portable floor lifts must be able to position patients
over the exam table; select a model that is compatible
with the table and room configuration
• A low-height, adjustable-width base can move closer
to the end of the exam table and can be narrowed for
transit and storage
• A low-height, adjustable width base permits the lift to
be positioned at the end of the examination table
10
Assisted Transfer –
with Transfer Board & Gait Belt with Handles
Transfer or sliding
board acts as a bridge
between wheelchair Gait belt with
seat and table surface handles assists
with guiding along
transfer board
11
Types of Safe Patient Handling and Mobility
(SPHM) Solutions
Consider reducing strenuous lifting by creating or
adopting SPHM policies and training, and by purchasing
lift equipment.
Examples include:
• “A “Minimal Lift Program” where nurses and other
health workers can work together
• Lift “Coaches” who work with staff to promote safety
• Height-adjustable exam tables
Think before you lift!
12
Resources
How To Be Barrier Free
This 10-minute Midmark Medical video explores how exam
tables reduce patient transfer injuries and make clinic visits more
accessible to a growing population of seniors and individuals
with disabilities.
Safe Patient Handling and Mobility

Section of the American Nurses Association website features
videos, PDFs, and links to publications, media coverage, and
lobbying efforts in support of safe patient handling standards.
Association of Safe Patient Handling Professionals (ASPHP)

Provides information on certification and links to a wide range
of resources, including webinars, publications, case studies, and
legislative updates.
Association of Occupational Health Professionals

in Healthcare (AOHP)
Main website of the AOHP, an organization dedicated to promoting
the health, safety, and well-being of health care workers through
advocacy, education, and research.
Safe Patient Handling: The Lift Coach Model

This Risk Authority video (Stanford Medical) introduces the
“lift coach” model for SPHM, promoted as more cost effective
than lift teams and minimal lift programs.
13
Provider Relations Team
Contact Information
Call: (909) 890-2054, Mon–Fri, 8am–5pm
Email: [email protected]
©2017 Inland Empire Health Plan. All Rights Reserved. MDS-16-06321

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Safe Transfers:

Assisting Patients with Disabilities

Some individuals need assistance getting on and off exam

Using the proper method for transferring individual

Prepare the Patient:

Here’s a checklist for two common types of transfers.

Some people require total lift assistance and, because of

2 Ensure the individual is safe and able to maintain

3 Do not leave people unattended if there is any chance

4 Record what worked for the patient in their record.

Medical staffs will likely need training on equipment

Notes about Portable Floor Lifts:

Think before you lift!

Safe Patient Handling and Mobility

Association of Safe Patient Handling Professionals (ASPHP)

Association of Occupational Health Professionals

Safe Patient Handling: The Lift Coach Model

©2017 Inland Empire Health Plan. All Rights Reserved. MDS-16-06321

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