{"id":1937,"date":"2015-03-31T20:43:53","date_gmt":"2015-03-31T20:43:53","guid":{"rendered":"http:\/\/opentextbc.ca\/clinicalskills\/?post_type=chapter&p=1937"},"modified":"2021-06-09T15:05:55","modified_gmt":"2021-06-09T15:05:55","slug":"3-6-transferring-and-ambulation","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/clinicalskills\/chapter\/3-6-transferring-and-ambulation\/","title":{"raw":"3.4 Immobility and Assisting Patients","rendered":"3.4 Immobility and Assisting Patients"},"content":{"raw":"When patients are recovering from illness, they may require assistance to move around in bed, to transfer from bed to wheelchair, or to ambulate. Changing patient positions in bed and mobilization are also vital to prevent contractures from immobility, maintain muscle strength, prevent pressure ulcers, and help body systems function properly for optimal health and healing (Perry et al., 2014). The amount of assistance each patient will require depends on the patient's previous health status, age, type of illness, and length of stay (Perry et al., 2014).\r\n

Types of Assistance<\/h2>\r\nAt times, patients are assessed and given a \"level of assistance\" required for transferring. This is most common in residential care settings. The level of assistance is based on the patient's ability to transfer and stand. The terms describing different levels of assistance are used by health care providers to communicate with each other so everyone understands what type of assistance is required. The assistance needed is usually charted on the patient's Kardex, above the head of the bed, and\/or on the patient's chart. Table 3.4 describes different types of assistance in the hospital and community setting.\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n\r\n
Table 3.4 Level of Assistance<\/caption>\r\n
Level of Assistance<\/strong><\/td>\r\nDescription<\/strong><\/td>\r\n<\/tr>\r\n
\u00a0<\/strong>Independent<\/td>\r\nThe patient is able to transfer independently and safely.<\/td>\r\n<\/tr>\r\n
Standby supervision<\/td>\r\nThe patient requires no physical assistance but may require verbal reminder.\r\n\r\nThis type of patient may also be learning to transfer independently using a wheelchair, walker, or cane.<\/td>\r\n<\/tr>\r\n
Minimal assist<\/td>\r\nThe patient is cooperative but needs minimal physical assistance with the transfer.<\/td>\r\n<\/tr>\r\n
One-person standing pivot<\/td>\r\nThe patient can bear weight on one or both legs and is cooperative and predictable.\r\n\r\nThe patient also can sit with minimal support on the side of the bed.<\/td>\r\n<\/tr>\r\n
Two-person standing pivot<\/td>\r\nThe patient can assist with weight bearing, but may be inconsistent.\r\n\r\nThe patient is cooperative and predictable.<\/td>\r\n<\/tr>\r\n
One-person assist with transfer board<\/td>\r\nThe patient is cooperative, follows directions, and has good trunk control.\r\n\r\nThe patient can use their arms, but cannot bear weight on both legs.<\/td>\r\n<\/tr>\r\n
Two-person assist with transfer board<\/td>\r\nThe patient is cooperative and can follow directions.\r\n\r\nThe patient can use their arms, but cannot bear weight on both legs. The patient does not have good trunk control.\r\n\r\nThe patient's wheelchair has removable arms.<\/td>\r\n<\/tr>\r\n
Mechanical stand<\/td>\r\nThe patient may have some ability to stand, but is unreliable.\r\n\r\nThe patient may be unpredictable (due to cognitive changes, medications).\r\n\r\nThe patient is a heavy two-person transfer and requires toileting or pericare.\r\n\r\nThe patient does not have severe limb contractures or injuries where\u00a0movement\u00a0is medically contraindicated (e.g., spinal injury).\r\n\r\nUse of a mechanical lift<\/a>.<\/td>\r\n<\/tr>\r\n
Data source:\u00a0Winnipeg Regional Health Authority (WRHA), 2008<\/td>\r\n<\/tr>\r\n<\/tbody>\r\n<\/table>\r\n
Special considerations:<\/h5>\r\n