Pt Care Procedures: Transfers

Front 1

TRANSFERS

what should be done prior to the transfer?

Back 1

Before initiating a transfer the therapist should get as much info about the pts abilities as possible to determine the best transfer.

Front 2

best course of action if you are in doubt about the level of assistance you may need in a transfer?

Back 2

If you are in doubt about the level of assistance you need, always have a second person available

Front 3

Dependent transfer

how much assistance from patient?

Back 3

minimal or no active participation by the pt.

Front 4

Types of Dependent Transfers

4

Back 4

sliding - draw sheet or transfer board
3 person carry
dependent stand pivot
hydraulic lift

Front 5

Assisted transfers

how much assistance from the patient?

Back 5

require some pt participation

Front 6

Assisted transfers

types...3

Back 6

2 person lift
sliding board
assisted stand pivot

Front 7

max assist of 1-3

what % of work does therapist do?

Back 7

therapist does 75% or more of transfer

Front 8

mod assist of 1-3

what % of work does therapist do?

Back 8

therapist does 50% of the transfer

Front 9

min assist of 1-3

what % of work does therapist do?

Back 9

therapist does 25% of the transfer

Front 10

Stand By Assist (SBA) or Contact Guard Assist (CGA)

what % of work does therapist do?

Back 10

therapist does less than 25% of the transfer

Front 11

"assisting" can include what types of additional techniques?

Back 11

Assist can be verbal cueing, balance control and lifting/ supporting

Front 12

what are two major reasons to have direct contact with a patient during a transfer?

Back 12

1. allows the therapist to maintain the best biomechanical posture while working with the patient

2. manual contacts provide input to the pt concerning direction of movement

Front 13

Transfer belts are extremely important when used properly for what reasons?

Back 13

allows safety if used properly but does decrease manual contact to pt
some hosp/ rehab centers require them, part of protocol and helps in legal situations
some facilities prohibit use, as would rather contact pt.

Front 14

what is the purpose of "transfers"?

Back 14

Purpose of transfers is to permit pts to function in different environments or use different pieces of equipment.

Front 15

what is the GOAL of transfer training?

Back 15

Goal of transfer training is to increase the level of independence of a pt.

Front 16

will transfer technique always be "by the book"?

Back 16

You can generalize your transfer technique to multiple situations with slight modifications

Front 17

Key points to remember when teaching and performing transfers...

Back 17

always inform your pt about what you are doing and what the pt is expected to do
use commands and contacts to synchronize the actions of all involved

Front 18

who is "in charge" during a transfer?

Back 18

the person at the head of the pt usually gives the commands

Front 19

when is a transfer complete?

Back 19

the transfer is not complete until the pt is safely in a new position

Front 20

Draw sheet/sliding transfer.
3 people required

basic technique?

Back 20

put stretcher, if possible, next to unaffected side. grasp draw sheet with supinated arms. 2 people toward movement, one on the opposite side. watch body mechanics, bring knees up onto bed if necessary. move 1/2 way, reposition, and then complete

Front 21

when should a 3 person carry (lift) be used?

Back 21

used only if a sliding transfer can not be used

Front 22

3 person carry/lift

basic technique?

Back 22

position stretcher at a right angle to the pt. remove your jewelry to avoid scratching. tallest therapist at head, strongest in the middle, one at legs. move pt close to you, edge of mat. curl and lift. move as a unit to new surface. lower and uncurl
scoot toward middle of new surface

Front 23

Stand/Swing Pivot

basic technique?

Back 23

put wheelchair as close to surface as possible, parallel. lock and remove all extra appliances, parts
move pt forward, hip walk or push back/ hips forward ( if required)
place gait belt around pts waist snuggly. block pts feet and knees with yours bilaterally ( or one LE or none as required). put your arms around pts waist either inside or outside pts arms depending on pts control and hold gait belt securely
DO NOT allow pts to put arms around your neck.

Front 24

Stand/Swing Pivot

when used?

Back 24

pt can bear LE weight, but can't stand independently

Front 25

Stand/Swing Pivot

purpose of generating momentum?

Back 25

Use momentum, rocking forward and backward, and counting so that all effort is given at same time ( if required)

Front 26

Hoyer Lift

Key points?

Back 26

basically a sling seat. has a weight limit. works on a hydraulic pump unit. can be used to lift very heavy or totally dependent people from the floor/bed into bed/chair
can also be used a bathing aid, to get to perineal parts for thorough cleaning

Front 27

2 person lift-wc to floor, mat to wc,etc

basic technique?

Back 27

lock wc and remove all extra appliances
cross pts arms and grasp the wrists, or may use gait belt
straddle wheel
second person holds under thighs and lower legs, and faces direction of transfer
lift, clear and lower

Front 28

sliding board- no LE use or NWB bilateral LE

basic technique?

Back 28

place sliding board under bottom and on surface sliding to
make sure LE are positioned non skid shoes
push and slide body
careful of fingers
remove board from under bottom

Front 29

side to side wt shift- to scoot toward edge of seated surface

basic technique?

Back 29

one arm around neck /shoulder of pt
opposite arm at opposite hip or post knee of pt

Front 30

Pelvic Slide

basic technique?

Back 30

pt pushes upper body back into chair, therapist assists pulling bottom forward

Front 31

sitting push up-

basic technique?

Back 31

pt pushes up on armrests, therapist assists hips forward

Front 32

push up transfer-

basic technique?

Back 32

paras, no sliding board used

Front 33

Floor to wc

basic technique?

Back 33

therapist lowers handles of wc to floor, assist pt out; slide pt forward and lift

Front 34

forward out of wc independently forward

basic idea?

Back 34

scoot forward to edge of seat
lower hand to casters
lower bottom to floor

Front 35

power lift floor to wc (backwards)

basic technique?

Back 35

back up to wc
hands on casters or foot rests
lift bottom to edge of chair
hands on handrails
scoot bottom back

Front 36

turn and lower

basic technique?

Back 36

slide legs out and twist body on the way down

Front 37

turn and lift

basic idea?

Back 37

forward and twist body until seated

Front 38

forward fall

basic technique?

Back 38

fall to knees and then hands car, bath tub bench, bs commode

Front 39

why teach transfer to both side of patient?

Back 39

Pt must be safe and able to transfer to either side to be independent.

Teach transfer to both sides, not just the strong side

Front 40

Guarding- involved vs uninvolved.

key points to remember?

Back 40

Keep your feet out of the line of movement

Front 41

Changing your hand position will facilitate different movements

such as...

Back 41

under buttocks - lifts pt
side of pelvis- guides movement
ant pelvis- apply resistance for strengthening and movement facilitation