Therapeutic Procedures : Transfer Training & Levels of Assist Flashcards
Transfers
Safe movement of a person from on surface to another.
Safe movement of a person from on position to another.
Equipment Used in Transfers (5)
- Draw Sheet
- Sliding Board
- Gait Belt
- Overhead Bar
- Hoyer Lift
Level of Assistance for Transfers, Gait, and Dressing Training (7)
- Independent
- Supervision
- Contact Guard
- Min A.
- Mod A.
- Max A.
- Total A.
Level of Assistance: All tasks of activity are performed safely, without modification, adaptive equipment, or aids.
Transfer is completed in a reasonable amount of time.
Independent
Level of Assistance: Client requires no more help than standby, cueing or coazing, w/o physical contact.
Client may need help setting up for the transfer or applying othosis.
Supervision
Level of Assistance: Client may require in addition to set up and supervision guidance by touching to as a security for balance loss.
Pt. expends effort independently requiring assistance only in event of rare balance loss
Contact Guard
Level of Assistance: Client requires no more help than touching and physical guidance.
Client expends 75% or more of the effort
Minimal Assistance
Level of Assistance: Client requires more help than touching, requiring assistance to lift and move part of the pts. body weight.
Client expends up to half (50%) or more (up to 75%) of the effort.
Generally require 2 persons to transfer
Moderate Assistance
Level of Assistance: Client require much assistance to move body weight.
Client expands less than 50% of the effort but more than 25%
Maximal Assistance
Level of Assistance: Pt. requires assistance to lift and move most of body weight.
Client expands less than 25% of the effort.
Generally requires mechanical lift
Dependent / Total Assistance
How to Decide level of Assistance (6)
- Medical Chart
- Precautions
- Physical Abilities
- Cognition
- Preparation
- Team Approach
Transfer Documentation (4 Keys)
- Describe the # of persons needed to assist.
- Equipment used (slide board, hoyer lift)
- Type (stand pivot, bobath)
- Level of Assistance
Type of transfer where the pt. is brought to a full stand then turns in a pivot to face other surface before sitting down.
Stand Pivot Transfer (SPT)
Steps to set up a SPT w/c to bed (4)
- Apply gait belt.
- Remove footrests or swing away
- Position w/c parallel or at 45-60 degree angle to bed midway between head and foot of bed.
- Lock brakes, assure castors are forward for wider base of support.
Steps of a SPT w/c to bed (5) (Pepping to stand)
- Move pt. forward in chair by assisting pelvis forward.
- Keep pts. feet apart and under pt.
- Touch your knees to the pt.
- Have pt. place hands on arm rest.
- Hold gait belt near pelvis on side.
Steps of SPT w/c to bed continued (4) (Standing)
- Encourage pt. to lean forward w/ “nose over your toes”.
- Give cue to stand “1-2-3 stand”
- May need to rock for momentum.
- Encourage pt. to push with hands.
Steps of SPT w/c to bed continued (5) (Standing to bed)
- As you stand, watch for buckling knees
- Pivot carefully, assisting feet as needed
- Ask pt. to reach back with hand.
- Slowly lower down
- Scoot back onto bed
SPT w/ Assist (4 points)
- Watch for stabilizing knees and hips.
- May need to assist in pivoting.
- May need to guide feet or affected foot with your foot.
- May need assistance to maintain balance on sitting.
SPT : Complications w/ Hemi paresis (4 points)
- Moving toward unaffected side in training
- reasons for moving toward affected side.
- Consider cognitive and perceptual limitations.
- Allow sufficient time for pt. to do tasks on own.
Sitting Transfer w/ Sliding Board (SBT) (4 steps for setting up)
- Remove both foot rests and arm res closest to destination (ie. bed).
- Position w/c parallel or at 45-60 degrees to bed
- Lock brakes
- Apply gait belt
SBT continued (3)
- Position slide board under pts. thigh and buttock closest to bed.
- Pt. reaches toward other end of sliding board and pulls self, sliding toward destination.
- Therapist guides pts. knees and provides support for balance as needed.
Sitting Dependent Lift : Bobath (5 steps)
- Apply gait belt
- Remove footrests or swing away
- Remove arm rest closest to bed
- Position w/c parallel or at 45-60 degree angle to bed midway between head and foot of bed.
- Reposition patent upright
Bobath Continued (4)
- Move pt. forward in chair by assisting pelvis forward
- Keep pts. feet apart and under pt.
- Place pts. arms folded on lap.
- Stand in front of pt., flex your knees, keep your feet on outside of pts. knees and feet.
Bobath Continues (4)
- Flex pts. trunk far forward and place his head on side of your hip that is opposite the direction of your transfer
- Grasp pts gait belt at pelvis and lift from chair.
- Pivot body as unit and turn pts. buttocks toward bed or transfer object.
- Reposition pt. upright.
Two Person Lift (3)
- Position w/c parallel or at 45-60 degree angle to bed midway between head and foot of bed
- Remove footrests and armrest closest to destination.
- Lock brakes, assure castors are forward for wider base of support.
Two person life continued (5)
- Fold pts. arms over abdomen
- Taller persons stands behind chair and reaches through axilla, grasps pts. opposite forearms with hands.
- Other person hold and lifts legs
- Give command to lift : “1-2-3 lift”
- Lift up and over to surface slowly setting pt. down and repositioning.
Two Person Lift : Alternate Position
- Stand at pts. side facing second person
- Grasp other assistance forearms behind pts. back and under pts. knees.
- Give command “1-2-3 lift”
- Lift up and over to surface lowering slowly and repositioning.
