3.7 Patient Transfers

Disclaimer: Always review and follow your hospital policy regarding this specific skill.

Safety considerations: 

• Perform hand hygiene.
• Check room for additional precautions.
  
• Introduce yourself to patient.
• Confirm patient ID using two patient identifiers (e.g., name and date of birth).
• Listen and attend to patient cues.
• Ensure patient’s privacy and dignity.
• Assess ABCCS/suction/oxygen/safety.
  
• Ensure tubes and attachments are properly placed prior to the procedure to prevent accidental removal.
• A slider board and full-size sheet or friction-reducing sheet is required for the transfer.

Steps

 Additional Information

1. Always predetermine the number of staff required to safely transfer a patient horizontally.

2. Explain what will happen and how the patient can help (tuck chin in, keep hands on chest).

Collect supplies.

This step provides the patient with an opportunity to ask questions and help with the transfer.

3. Raise bed to safe working height. Lower head of bed and side rails.

Position the patient closest to the side of the bed where the stretcher will be placed.

The patient must be positioned correctly prior to the transfer to avoid straining and reaching.

May need additional health care providers to move patient to the side of the bed.

4. Roll patient over and place slider board halfway under the patient, forming a bridge between the bed and the stretcher.

Place sheet on top of the slider board. The sheet is used to slide patient over to the stretcher.

The patient is returned to the supine position.

Patient’s feet are positioned on the slider board.

The sheet must be between the patient and the slider board to decrease friction between patient and board.

Ensure all tubes and attachments are out of the way.

5. Position stretcher beside the bed on the side closest to the patient, with stretcher slightly lower. Apply brakes.

Two health care providers climb onto the stretcher and grasp the sheet. The lead person is at the head of the bed and will grasp the pillow and sheet. The other health care provider is positioned on the far side of the bed, between the chest and hips of the patient, and will grasp the sheet with palms facing up.

The two caregivers on the stretcher grasp the draw sheet using a palms up technique, sitting up tall, and keeping their elbows close to their body and backs straight.

6. The caregiver on the other side of the bed places his or her hands under the patient’s hip and shoulder area with forearms resting on bed.

7. The designated leader will count 1, 2, 3, and start the move.

The person on the far side of the bed will push patient just to arm’s length using a back-to-front weight shift.

At the same time, the two caregivers on the stretcher will move from a sitting-up-tall position to sitting on their heels, shifting their weight from the front leg to the back, bringing the patient with them using the sheet.

Using a weight shift from front to back uses the legs to minimize effort when moving a patient.

8. The two caregivers will climb off the stretcher and stand at the side and grasp the sheet, keeping elbows tucked in.

One of the two caregivers should be in line with the patient’s shoulders and the other should be at the hip area.

On the count of three, with back straight and knees bent, the two caregivers use a front-to-back weight shift and slide the patient into the middle of the bed.

The step allows the patient to be properly positioned in the bed and prevents back injury to health care providers.

9. At the same time, the caregiver on the other side slides the slider board out from under the patient.

10. Replace pillow under head, ensure patient is comfortable, and cover the patient with sheets.

11. Lower bed and lock brakes, raise side rails as required, and ensure call bell is within reach.

Perform hand hygiene.

Hand hygiene reduces the spread of microorganisms.

Disclaimer: Always review and follow your hospital policy regarding this specific skill.

Safety considerations: 

• Check room for additional precautions.
  
• Introduce yourself to patient.
• Confirm patient ID using two patient identifiers (e.g., name and date of birth).
• Listen and attend to patient cues.
• Ensure patient’s privacy and dignity.
• Assess ABCCS/suction/oxygen/safety.
  
• Ensure tubes and attachments are properly placed prior to the procedure to prevent accidental removal.
• A gait belt and wheelchair are required.

Steps

 Additional Information

1. One health care provider is required.

2. Perform hand hygiene. Explain what will happen during the transfer and how the patient can help.

Apply proper footwear prior to ambulation

This step provides the patient with an opportunity to ask questions and help with the positioning.

3. Lower the bed and ensure that brakes are applied.

Place the wheelchair next to the bed at a 45-degree angle and apply brakes. If a patient has weakness on one side, place the wheelchair on the strong side.

4. Sit patient on the side of the bed with his or her feet on the floor. Apply the gait belt snugly around the waist (if required).

Place hands on waist to assist into a standing position

The patient’s feet should be in between the health care provider’s feet.

5. As the patient leans forward, grasp the gait belt (if required) on the side the patient, with your arms outside the patient’s arms. Position your legs on the outside of the patient’s legs. The patient’s feet should be flat on the floor.

6. Count to three and, using a rocking motion, help the patient stand by shifting weight from the front foot to the back foot, keeping elbows in and back straight.

7. Once standing, have the patient take a few steps back until they can feel the wheelchair on the back of their legs. Have patient grasp the arm of the wheelchair and lean forward slightly.

8. As the patient sits down, shift your weight from back to front with bent knees, with trunk straight and elbows slightly bent. Allow patient to sit in wheelchair slowly, using armrests for support.

This allows the patient to be properly positioned in the chair and prevents back injury to health care providers.