Lying in bed for a long period of time is generally depressing and boring for most patients. To boost their spirits and make them more comfortable, you are required or patients will often ask for a change in position
and surroundings. The only way to do this is to safely transfer the patient from bed to chair or wheelchair. Being transferred to a chair enables the patient to execute some slight movements that is beneficial in improving circulation. Usisng a wheelchair serves as a way to transport a weak patient around the hospital areas for treatments such as x-ray, ultrasound, or to the lab. It is also beneficial in transporting the patient for a change of scenery that will help brighten his mood and increase his/her chance for socialization. This type of transfer should be done with extreme caution. Proper handling of the patient and proper body mechanics of the handler is instrumental regarding safety. If the patient has enough body strength to move, it is best to have them help you whenever possible.
- Non-skid socks
How to Transfer a Weak Patient from Bed to Chair/Wheelchair
Step 1- Assess the patients’ overall strength and check for cognitive impairment. Understanding where the patient’s weaknesses are will better allow you to execute the transfer properly. The patient’s cognitive level will help you realize if they have the capability of understanding or following instructions. Make sure the patient has their non skid socks on.
Step 2- Inform the patient on what you are about to do. If the patient wants to be transferred on a chair, explain the details of how the maneuver is done. And if there is a need for him to be transferred on a wheelchair, explain the purpose and destination of the transfer. Informing the patient about the actual maneuver will facilitate cooperation and will make them feel respected rather than controlled.
Step 3- Position the chair or wheelchair next to the bed facing the foot of the bed. Bring the chair as close as possible to reduce the distance of the transfer. If a wheelchair is used, make sure to lock its brake and fold the foot rests, as soon as you position it near the bed.
Step 4- Adjust the bed in its lowest position making it easier and safer for the patient to step down on the floor and decreasing the risk of falling. Lock the brake of the bed and then assist the patient in doing side lying position, facing the direction of the transfer.
Step 5- Lower the side rail of the bed and gradually raise the head of the bed up to a tolerable level. Constantly check the patient’s ability to tolerate the procedure
Step 6- Face the patient and place one arm under the shoulder of the patient and the other arm supporting the patients’ thigh on the opposite side. Count to three and then carefully swing the legs of the patient over the side of the bed and assist him in lifting his trunk and shoulders until he is in the sitting or upright position. If patient is strong enough to do some movements, allow the patient to participate in the maneuver as much as possible if tolerated. Then carefully swing both legs on the side of the bed and assist them in lifting his trunk and shoulders until he is in sitting position.
Step 7- Place your arms around the torso of the patient for support. Put one of the patient’s arms over your shoulder; while his other arm is extended on the bed, to help support the position. This means if the patient has a right sided weakness, you would have their left arm as the extended arm for support since it is the stronger arm. Instruct the patient to scoot over the edge of the bed until feet is flat on the floor. Let patient dangle for a minute while you are observing for dizziness.
Step 8- Widen the distance of your feet, with right foot forward, and the left foot back for an easy shift of your weight as you lift the patient. Maintain the position above, with your arms still supporting the torso of the patient. One arm of the patient should still be on your shoulder and his other arm should still be extended on the bed (palm flat on bed).
Step 9- Position your right foot alongside the patients’ left foot (the side to where the little toe is at) and position your leg on the level on his knee. The positioning of your foot and leg provides stability by preventing slipping of the patients’ foot and knee buckling when he is lifted to standing position.
Step 10- Slightly bend your knees and lean your body. Then instruct the patient to get ready to push from one arm that’s extended on the bed, as you lift them to standing position. Count to three as you assist the patient to standing position and he is pushing off from at the same time on three.
Step 11- Raise patient to standing position and keep your back straight as you do this maneuver. Pivot the patient so that his back is positioned in front of the chair or wheelchair; instruct him to grasp on the armrest for additional support, and then slowly assist the patient as he lowers himself on the seat of the chair. Remember to bend your knees, while keeping your back straight during the assist for ergonomic safety.
Step 12- Help the patient in positioning himself properly when seated. Make sure that his buttocks are entirely rested on the seat and his back firmly resting on the back support. When in a wheelchair, place his arms on the armrests and his feet on the footrests. Also make sure the clothing is straight and the patient is comfortable as well as how they tolerated the transfer.
Step 13- Document the safe transfer of the patient and the patient’s tolerance.
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