1. Copyright © 2008 Delmar Learning. All rights reserved. Unit 16 The Patient’s Mobility: Transfer Skills

2. Copyright © 2008 Delmar Learning. All rights reserved. Objectives Spell and define terms. List the guidelines for safe transfers. Describe the difference between a standing transfer and a sitting transfer. Demonstrate correct application of a transfer belt.

3. Copyright © 2008 Delmar Learning. All rights reserved. Objectives List at least seven factors to consider before lifting or moving a patient to determine whether additional equipment or assistance is necessary. Apply the principles of good body mechanics and ergonomics to moving and transferring patients.

4. Copyright © 2008 Delmar Learning. All rights reserved. Introduction As a nursing assistant, you will work with many patients who have impaired mobility. In the last unit, you learned how to move and position patients in bed. In this unit, you will learn how to transfer patients.

5. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Patient lifts and transfers are listed as tasks with the highest risk of injury because: –Workers end up in awkward positions and confined spaces –Workers are bending or reaching while the back is flexed

6. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Factors that further increase the risk of injury are: –Patient weight –Transfer distance –Confined workspace –Lateral patient transfers –Unpredictable patient behavior –Stooping, bending, and reaching

7. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Although the nurse or therapist selects the method of transfer –You will need to determine if you will need another person or piece of equipment to assist you

8. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Key elements for you to consider are: –Patient’s ability to assist with the procedure –Patient’s ability to bear weight –Patient’s upper extremity strength –If a sliding board or certain other transfers are used

9. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Key elements for you to consider are: –Patient’s ability to cooperate and follow directions –Patient’s size (height and weight) compared with your size

10. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Key elements for you to consider are: –If the patient is larger than you are You may need help from another assistant or a mechanical device –If the patient is smaller than you are, is dependent, or cannot cooperate You may also need help

11. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Key elements for you to consider are: –Wounds –Surgical sites –Catheters, IVs, tubes, contractures, etc. that restrict or interfere with mobility Always get help if there is danger of removing a tube during transfer

12. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Key elements for you to consider are: –Special physician orders or therapy recommendations for transfers and positioning Such as you would see in a patient who has had hip surgery

13. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Some facilities have implemented “no lift” policies –“No manual lifting” should be done

14. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Facilities with “no lift” or “zero lift” policies –Usually depend on mechanical aids to reduce friction when moving a patient

15. Copyright © 2008 Delmar Learning. All rights reserved. Nursing Assistant Safety Some use a combination of mechanical, electrical, and ceiling-mounted lifts for moving patients vertically Many facilities require the use of gait belts

16. Copyright © 2008 Delmar Learning. All rights reserved. Types of Transfers Basic types of transfers are: –Standing transfer –Sitting transfer –Lateral transfer –Vertical transfer Done with a mechanical lift

17. Copyright © 2008 Delmar Learning. All rights reserved. Transfers A transfer belt –Webbed belt 1½ to 2 inches wide and about 54 to 60 inches long –Assistive and safety device used to transfer or ambulate patients

18. Copyright © 2008 Delmar Learning. All rights reserved. Transfers During transfer and when wheelchair is parked –Always position small front wheels facing forward and lock brakes Refer to Figure 16-2

19. Copyright © 2008 Delmar Learning. All rights reserved. Transfers

20. Copyright © 2008 Delmar Learning. All rights reserved. Transfers A sliding board is a plastic or wooden board that is about two feet long with a slippery surface It is used for a sitting lateral transfer

21. Copyright © 2008 Delmar Learning. All rights reserved. Stretcher Transfers To move a patient from his or her room to another room for surgery, treatment, or diagnostic testing Procedure may be very frightening to the patient –Assure patient that procedure is safe

22. Copyright © 2008 Delmar Learning. All rights reserved. Moving the Patient with a Mechanical Lift For moving heavy patients who have little or no ability to assist Safer for both the patient and nursing assistant

23. Copyright © 2008 Delmar Learning. All rights reserved. Moving the Patient with a Mechanical Lift Moves patient from one surface to another by means of a vertical transfer Many types of mechanical lifts are used

24. Copyright © 2008 Delmar Learning. All rights reserved. Toilet Transfers Bladder is emptied much more efficiently if a patient can use a toilet or commode rather than a urinal or bedpan To use the toilet –Patient must possess transfer skills

25. Copyright © 2008 Delmar Learning. All rights reserved. Tub Transfers In the institutional setting –A shower with chair or a tub with hydraulic lift is available If the patient is at home –A tub chair, a rail on the wall beside the tub, and slip-proof mats in the tub are needed for safety

26. Copyright © 2008 Delmar Learning. All rights reserved. Car Transfers You may need to assist a patient –Transferring into a car when he or she is discharged from the hospital If you are working in the patient’s home –It may be your responsibility to assist the patient when going in and out of a car