General Mobility Guidelines CSU School of Nursing Fall 2016 Maureen Whitford, PT, PhD, NCS Matt Burnett, SPT Jenna Faiella, SPT Angela Formanik, SPT Jenna Heffernan, SPT Alexa Katrinchak, SPT Sarah Popernack, SPT Josh Scribben, SPT Amanda Videmsek, SPT

Acknowledgement Composed primarily by Amanda Videmsek, SPT (slight edits from Dr. Whitford)

Moving a Patient Up in Bed (2 Person Sheet Lift) Place draw sheet under patient Gather sheet close to patients trunk and pelvis and grasp firmly On the count of 3, lift or slide patient upward/downward in bed; put bed in Trendelenberg if person big/total assist Maintain proper body mechanics during transfer Wide base of support Bend with hips and knees – not back

Bed to Cart Transfer (3 person slide/lift; using sheet) Designate a leader (to count, be in charge) Place sheet under patient 2 Lifters on one side of patient Trunk and low back Pelvis and legs 1 Lifter on opposite side of bed (body mechanics) Gather sheet and grasp close to patient On command lift/slide patient towards cart Move patient toward center of the new surface *May need to do in 2 steps *May use plastic board or Jimmy slide(?)

Bed  Wheelchair Transfer (Stand Pivot) Explain & put gait belt on patient (don’t put up under arms) Lock & position wheelchair (45-60° angle to bed) Assist patient to scoot forward to put feet flat on ground Patient leans forward (“nose over toes”) to initiate transfer Patient pushes through arms and legs Assist patient to stand using gait belt (use good body mechanics) Give patient a minute to stand before pivoting Patient pivots by taking small steps; let patient do as much as able; **Use walker if used in PT To sit: patient reaches back toward armrest and lowers slowly into chair with assistance as needed

Ambulation with 1 Person Stand slightly behind and toward patient’s weak side Position one hand on gait belt and one hand on shoulder or upper chest Place your feet in A/P stance Walker: move walker, weak leg, strong leg Cane: just walk naturally Crutches: *depends

Ambulation with 2 people (no device) *Usually if you need people, the person would do better WITH a device (walker, etc.) Explain & put gait belt on Maintain grasp on gait belt (not under arms) & 1 hand anterior gently on their chest Each person stand to either side of patient Move forward in step with patient Alternative: One nurse stands slightly behind and toward patient’s weak/involved side holding gait belt Second nurse follows with WC or carries/manages equipment during ambulation

References 1. Fairchild S. Pierson F. Pierson And Fairchild's Principles & Techniques Of Patient Care. St. Louis, Mo.: Elsevier; 2013.