Bed Mobility and Transfers

Question 1

List 3 important rules for safe body mechanics in transferring a person from bed to chair.

Answer 1

1. Increase base of support
2. Lowering your center of gravity
3. Maintaining your vertical gravity line (VGL)
4. Positioning your feet according to the direction of movement you will use to perform
   the activity

Question 2

What does “nose over knees over toes” mean in conducting a transfer?

Answer 2

Creates hip flexion to initiate movement , client shifts their weight & COG forward by bringing their head forward over knees as therapist lifts (“1, 2, 3, stand”)

Question 3

What is the importance of Center of Gravity (COG) in performing a transfer?

Answer 3

COG=point at which the mass of the body is centered (~second sacral segment) & is heaviest area to move; want to position your COG as close to the client’s COG as possible during transfer (to increase stability - widen BOS and lower COG)

Question 4

What are the pros and cons of using a gait belt in performing transfers?

Answer 4

(+) Gait belt provides secure object to grasp during transfer; decreases need to use pt. clothing
(-) Not good if pt. has poor skin integrity in area of gait belt, can obstruct any equipment attached to pt. (catheters/drainage tubes, IV tubes, dressing sites, etc.)

Question 5

Name the four steps of the Egress Test.

Answer 5

1. One-inch test: lift self one inch off bed
2. Stand up 2 times
3. March in place (at least 3 alternating steps)
4. Step forward and back (3 times)

Question 6

Why do you do the Egress Test?

Answer 6

Measures a client’s ability to transfer and helps determine which type of transfer to use

Question 7

According to the Egress test, what type of transfer should you use when the client can: one-inch raise

Answer 7

Sliding board, Squat-pivot transfer

Question 8

According to the Egress test, what type of transfer should you use when the client can: stand up twice

Answer 8

Squat-pivot transfer

Question 9

According to the Egress test, what type of transfer should you use when the client can: march in place

Answer 9

Step-turn transfer (aka stand-pivot with UE support)

Question 10

According to the Egress test, what type of transfer should you use when the client can: step in place

Answer 10

Walking transfer

Question 11

List 3 situations when you may wish to use a mechanical lift to help transfer a bariatric patient.

Answer 11

1. inability to lift trunk away from bed at 45 degree angle
2. inability to move legs against gravity in supine
3. inability to maintain erect seated at bedside with feet supported
4. vital signs outside normal range
5. insufficient staff numbers
6. significant change in mental/physical status

Question 12

Describe how to safely lift an object from the floor using proper body mechanics.

Answer 12

1. Position yourself (COG) as close to object as possible
2. Spread your feet to widen your BOS
3. Squat, keeping a straight back & tight abs→ bend your knees! (lowers your COG)
4. Grasp either side of the object
5. Lift using your quads and maintain a vertical spine
6. Bring object close to body while lifting