Planning the Transfer

Listen to a quick instruction from Christina (approximately 3 minutes)

  1. Read the medical record

    1. Arousal, attention, cognition assessment
    2. Precautions and contraindications (weight bearing status, post-surgical status, vital sign parameters for activity, etc.)
    3. Other relevant medical conditions: e.g., skin/bandages, corsets/braces, infectious diseases
    4. Transfer type and level of assist on eval and in recent past (with PT or other members of health care team where applicable).
  2. Approach the patient
    1. Introduce yourself as: (your name), "Student Physical Therapist Assistant" or "Student PT Assistant" from Lane Community College
    2. Generally describe the transfer activity. Avoid jargon, over explanation. Keep it simple: "I'd like to work with you on improving your ability to move around in bed".
  3. Interview the patient to screen for their abilities. For example, ask:
    1. How did you get into the wheelchair?
    2. Do you feel dizzy or light headed when you stand up?
    3. How do you get to the bathroom?
    4. How much help do you need?
  4. Briefly confirm their mobility status and ability to participate by completing a brief assessment
    1. For example, ask pt to move arms, legs, reach across, perform weight shifts in sitting, etc.)
    2. Check for postural hypotension
    3. Balance
    4. Patient motivation
    5. Pain
  5. Select and collect equipment - Listen to a 1 minute tip from Christina
    1. Equipment should coincide with information in the PT evaluation, your gross motor assessment, patient subjective information (pain, endurance, etc)
    2. Essential equipment for all transfers into upright postures is a GAIT BELT
    3. Equipment for monitoring vital signs should be gathered and ACCESSIBLE during the transfer activity
      1. transfer belt (aka gait belt)
      2. non-skid footwear
      3. appropriate draping material: robe, sheet, etc.
      4. wheelchair with brakes, elevating or removable leg rests as appropriate (or stretcher)
      5. equipment (slide board, Hoyer lift, etc., as needed)
      6. support garments (back support, leg brace, slings. etc.) as needed
  6. Prepare the environment and equipment
    1. Assist patient as needed with clothing, splinting, etc. prior to initiating transfer
    2. Coordinate support or additional staff as needed prior to initiating transfer
    3. Appoint a therapist as the "lead" and set roles and responsibilities for assisting with transfer, including reviewing the sequence of activities/events for a successful transfer
    4. Adjust bed/mat heights for maximum safety (therapist/patient)
    5. Check bed, bedrails, mat and/or wheelchair locks/parts for security
    6. Inspect floor and immediate transfer surface for obstacles, spills, and adequate slack in lines and tubes
    7. Pull curtain where applicable to offer privacy
  7. Confirm your patient understands the activity
    1. Ask he/she to repeat the steps of the transfer
    2. Consider breaking down transfer into smaller component parts to confirm understanding of task sequence.
  8. Use good body mechanics
    1. Wide base of support, feet positioned to allow for easy transition of weight from one foot to the other.
    2. Be prepared to keep your center of gravity as close to client's center of gravity as possible.
    3. Leg muscles and weight shifting are the key elements of a safe transfer.
    4. Ask for a second person to assist depending on the size and status of the patient.
    5. Respect your own lifting limitations: work within your comfort zone.

Video Summarizing Transfer Elements and Planning the Transfer - Listen to a 30 second tip from Christina

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