8.1 Introduction
In health care, all client-handling activities, such as positioning, transfers, and ambulation, are considered high risk for injury to clients and health care providers. This unit reviews the essential guidelines for safe transfer and moving techniques to minimize and eliminate injury in health care. When transferring clients, it is important to consider proper body mechanics (see Unit 3 Body Mechanics).
Learning Objectives
Upon completion of this unit, the successful student will be able to:
- Discuss point-of-care risk assessment and four areas of attention required when moving clients.
- Describe how different levels of assistance affect decisions about assisting with mobility and transfers.
- Describe various techniques for positioning a client in bed and types of positions.
- Describe the process of a one-person transfer assist from bed to a wheelchair including the use of any assistive device.
- Describe how to transfer a client from a stretcher to a bed using an assistive device.
- Discuss situations where mechanical assistive devices are necessary when moving clients.
- Discuss fall prevention strategies.
Terms to Know
The act of moving or walking a client from one place to another. Once a client is assessed as safe to ambulate, the nurse must determine if assistance from additional health care providers or assistive devices is required.
An object or piece of equipment designed to help a client with activities of daily living, such as a walker, cane, gait belt, or mechanical lift.
The client’s head of bed is placed at an angle between 45 degrees and 60 degrees. Hips may or may not be flexed. It’s a common position to provide client comfort and care.
Rubbing of two surfaces together, such as the skin rubbing against a sheet.
The assessed and determined level of assistance a client requires based on their ability to transfer, stand, and cooperate in care activities.
A hydraulic lift, usually attached to a ceiling, used to move clients who cannot bear weight, are unpredictable or unreliable, or have a medical condition that does not allow them to stand or assist with moving.
A policy that says health care providers are not to manually try to lift a client as this may result in serious injury to the client or care provider.
The client sits at the side of the bed with head resting on an over-bed table on top of several pillows. This position is used for clients with breathing difficulties.
Low blood pressure that causes dizziness, light-headedness, and even fainting when one goes from a lying or sitting position to a standing position. Also called postural hypotension.
When the client lies on their stomach with the head turned to one side.
Slightly lower than Fowler’s position, the client is seated in bed at a 30–45-degree angle. The client’s head of bed is placed at a 30-degree angle. This position is used for clients who have cardiac or respiratory conditions and for patients with a nasogastric tube.
When skin sticks to a surface, such as a sheet, and the muscles underneath slide in the direction the body moves.
The client lies between supine and prone position with legs flexed in front of the client. Arms should be comfortably placed beside the client, not underneath.
The client lies flat on their back, facing upward. Additional supportive devices may be added for comfort.
Moving a client from one flat surface to another, such as from a bed to a stretcher.
A position that places the head of the bed lower than the feet. Client lays flat on their back with feet elevated higher than their head by 15–30 degrees. Used in situations such as hypotension and medical emergencies, this position helps promote venous return to major organs such as the head and heart.
A sensation of whirling in which an individual or the individual’s environment is spinning, making the individual feel dizzy
