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