RACADIO, JEMINA R.

RACADIO

BSN2A

Activity: Nursing Procedure Notebook/ Nursing Procedure Diary

TRANSFERING OF PATIENTS

INDICATIONS

The skill of effective transfer techniques can be delegated to nursing assistive personnel
(NAP). Patients who are transferred for the first time after prolonged bed rest, extensive
surgery, critical illness, or spinal cord trauma usually require supervision by the nurse.

Instruct NAP about:

·         Seeking assistance when moving or lifting a patient (e.g., when the patient is overweight,
medicated, or confused).

·         Patient limitations (e.g., changes in blood pressure, mobility restrictions) that affect safe
transfer techniques.

EQUIPMENTS

·         Transfer belt, sling, or lapboard (as needed)

·         Nonskid shoes, bath blankets, and pillows

·         Wheelchair (Position chair at 45- to 60-degree angle to bed, lock brakes, remove
footrests, and lock bed brakes.)

·         Stretcher (Position next to bed, lock brakes on stretcher, lock brakes on bed.)

TRANSFERING OF PATIENTS

STEPS RATIONALE

1.     Silently recite a prayer for the success of the To ensure that the procedure will be done
procedure. smoothly without error
2.     Assess client’s status Determine  mode of transfer and assistance
required to provide continuity.

3.     Identify client’s risks for problems with Determine risks of injury.

transferring.

4.     Explain procedure to client. Increase patient’s participation.

5.     Provide privacy. To help patient feel comfortable.      

6.     Wash hands Reduces transmission of microorganism.

7.     Transfer client                         

7.1 Assist client to sitting position (bed at  

waist level):

7.1.1 Place client in supine position

Enables nurses to assess patient's body
alignment continually.

7.1.2 Face head of bed and remove  pillows.

Proper positioning reduces twisting of your
body when moving patient.

Pillows cause interference when patient is

sitting up in bed.

7.1.3. Place feet apart, with foot nearer bed

behind other foot. Improves balance and allows transfer of body
weight as you move patient to sitting position

7.1.4. Place hand farther from client under

client’s shoulders and support client’s head Maintains alignment of head and cervical
and cervical vertebrae. vertebrae and allows for even lifting of
patient's upper trunk.

7.1.5. Place other hand on bed surface

Provides support and balance.

7.1.6. Raise client to sitting position by shifting

weight from front to back leg. Improves balance, overcomes criteria, and
transfers weight in direction you move
patient.
7.1.7 Push against bed using arm that is
placed on the bed surface. Divides activity between arms and legs and
protects back from strain. By bracing one
hand against mattress and pushing against it
as you lift patient, you transfer weight away
from your back muscles through your arm
onto mattress.

7.2   Assist client to sitting position on side

of bed with bed in low position:  

7.2.1. Raise head of bed 30 degrees.

  Facilitates raising patient to sitting position
and protects him or her from falling.

7.2.2. Turn client to side, facing you, on side 

of bed on which client will be sitting. Decreases amount of work needed by nurse
  and patient.                       

7.2.3. Stand opposite client’s hips. Turn

diagonally so you face client and far corner   Reduces twisting of your body because you
of foot of bed. are facing direction of movement.          
  Places your center of gravity nearer
patient.

7.2.4. Place feet apart, with foot closer to 

head of bed in front of other foot. Increases balance and allows transfer of
  body weight as you move patient to a sitting
position.                                                            
                          

7.2.5. Place arm nearer head of bed under

client’s shoulder to support client’s head and Maintains alignment of head and cervical
neck. vertebrae and allows for even lifting of
  patient's trunk.

7.2.6. Place other arm nearer head and  neck.

Supports hip and prevents patient from falling
backward during
procedure                                                          
                              
7.2.7. Move client’s lower legs and feet 
over side of bed. Pivot toward rear leg, allowing Decreases friction and resistance.
client’s upper legs to swing downward.

7.3  Transfer client from bed to chair with

bed   
in low position:

7.3.1. Assist client to sitting position on side 

of bed. Position chair at 45-degree angle to bed.Positions chair within easy access for             
transfer. Placing chair on patient's stronger
side allows patient to help with
transferring.                                                       
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                           
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          
                                                                          

7.3.2. Apply transfer belt of other transfer

aids to client, if needed. Transfer belt maintains stability of
patient during transfer and reduces risk for
falling.

7.3.3. Ensure that client has stable, nonskid 

shoes. Place strong leg forward and weak leg  Nonskid soles decrease risk of slipping during
back. transfer.                    

7.3.4. Spread feet apart

Ensures balance with wide base of support.
7.3.5. Flex hips and knees and align knees 
with client’s knees. Flexing knees and hips lower center of gravity
to object to be raised; aligning knees with
those of patient allows for stabilization of
knees when patient stands.

7.3.6. Grasp transfer belt from underneath,if

used Provides movement of patient at center of
, or reach through client’s axillae and place gravity. Never lift patients with upper-
hands on  client’s scapulae. extremity paralysis or paresis by or under
arms

7.3.7. Rock client up to standing position on

count of   three while straightening hips and legsRocking motion gives patient's body
and keeping   knees slightly flexed. Instruct clientmomentum and requires less muscular effort
to use hands to push up, to lift him or her.
if able.

7.3.8. Maintain stability of client’s weak or 

paralyzed leg with knee. Often patient maintains ability to stand on
paralyzed or weak limb with support of knee
to stabilize

7.3.9. Pivot on foot farther from chair.

Maintains support of patient while allowing
adequate space for patient to move.

7.3.10. Instruct client to use armrests on   

chair for support, and ease client into chair Increases patient stability.

7.3.11. Flex hips and knees while lowering client

into chair Prevents injury to nurse from poor body
mechanics.

7.3.12. Assess client for proper alignment   

for sitting position. Provide support for paralyzedPrevents injury to patient from poor body
extremities. Use lapboard or alignment.
sling to support flaccid arm. Stabilize legs  
with bath blanket or pillow.

7.3.13. Praise client’s progress, effort, and

performance. Continued support and encouragement
provide incentive for patient perseverance.
7.4. Perform three-person carry from bed to
stretcher (bed at stretcher level):  

7.4.1. Stand side by side with two other nurses,

facing side of client’s bed. Minimizes caregivers' stretching.

7.4.2. Assume responsibility for one of three 

areas head and shoulders, hips, or thighs Prevents patient from falling out of bed and
promotes safety.
 and ankles.

7.4.3. Assume wide base of support.

Ensures balance with wide base of support.

7.4.4. Lifters will place arms under client’s

head and shoulders, hips, and thighs, with Prevents injury during transfer.
fingers securely around other side of client’s
body.

7.4.5. Lifters will roll client toward them. On

count of three, lift client and hold against chest. Positions patient for placing friction-reducing
lateral transfer device.

7.4.6. on second count of three, all lifters step 

back and pivot toward stretcher, moving forwardTransfers
If patient smoothly and efficiently to
needed. the stretcher.
 

7.4.8. Assess client’s body alignment, place 

safety straps across client’s body, and raise sideSide rails prevent patient from falling off
rails of bed. stretcher.
 

8. Wash hands.
Reduces transmission of microorganisms.

9. Assess client’s tolerance and alignment with

each transfer. Minimizes risk for immobility complications.
10. Record each transfer and position  
change and client’s response and tolerance. Evaluates patient's response to postural
changes and activity.

11. Record and report any signs of redness (e.g.

over body prominences). Determines need for additional pain control or
alteration of technique of transferring

       

 REFERENCE:

POTTER PERRY

NINTH EDITION