Transfers 1: Test 2 Flashcards
what parts of a patients experiences would you consider prior to a transfer
have they done it before
if so, how much help did they need
do they use any type of device/orthotic
what patient abilities would you take into consideration prior to a transfer
strength
joint mobility
balance
pain level
cognition
endurance
motor control
what is your primary responsibility as a caregiver in regards to transfers
patient independence is a goal BUT primary responsibility is to provide assist to protect the pt to avoid injury
what are parts you should plan prior to a transfer
what is the purpose of the transfer
do you have the needed equipment
are the departure and arrival points safe
will you need help
should have plan A, B, and C (normal scenario, best case, and worse case)
importance of gait belts
improve safety of pt and caregiver
should always be a part of the plan
positioning of the gait belt
most often on waist
can be higher for pt comfort or facility dependent
how do you grip a gait belt
strong underhand grip (uses extrinsic muscles of wrist/hand)
DO NOT use a handle (uses more intrinsic hand muscles)
tuck loose ends
special circumstances that you might not put the gait belt around the abdomen
colostomy and ileostomy
supra-pubic catheters
feeding tubes-PEG/J tubes
recent chest, abdominal or spinal surgeries
chest tube
nephrostomy placement
rib fractures (go low)
trauma
fragile skin
age related anatomical changes
pt preference
all are reasons you could place gait belt higher under armpits or lower below ribs
other lines/tubes you should consider with gait belts/transfers
nasogastric tube
urinary catheter
rectal tube
nasal cannulus
tracheostomy lines
EKG electrode line
pulse oximeter
SCDs
benefits of good body mechanics
Less energy use
reduce strain on body tissues
promote safe and efficient movement
promote control and balance
what are out of bed transfers
sit to stand
stand pivot
seated transfers (i.e. squat pivot transfer, or sideboard)
what are situational transfers
bed to WC
WC to toilet
WC to car
bed to bed/stretcher
transfer considerations
pt starting position
wheelchair/target surface
pt ending portion (is it stable, safe, comfy, environmental access)
what do you need to be able to do to perform a sit to stand
prep the position
weight shift
rise
stand
how should a pt rise with a sit to stand
push down through feet and hands maintaining forward trunk flexion
pt bears weight through BLE to unweight rear end
06 GG code
no assistance required to complete task in normal time frame
05 GG code
setup/cleanup
pt may require verbal cues, assistive device, or additional time
04 GG code
verbal/tactile cues w/o touching
OR
therapist has hands on pt/gait belt to provide safety
03 GG code
partial assist
minimum or moderate
50-over 75% of activity performed by pt
02 GG code
max assist
pt performs 25-49% of activity
01 GG code
pt requires total physical assistance from one or more persons to accomplish task safely
dependent
rules for a squat pivot transfer
pt can bear weight safely through at least 1 LE
pt does not come to full stand however can lift and clear bottom from surface (caregiver must be strong enough to assist of needed; remember balance point/body mechanics)
no devices used
remove arm rest of WC
often more than 1 person assisting
rules for seated transfer “popover”
pt is unable due to weakness
pt can lift and clear bottom from surface with or without caregiver assist
pt must possess significant UE strength and trunk control
common terminology for 06 GG code
independent
common terminology for 05 GG code
modified independent
common terminology for 04 GG code
supervision
stand by assist
contact guard assist
common terminology for 03 GG code
minimal assist
moderate assist
common terminology for 02 GG code
maximal assist
common terminology of 01 GG code
dependent
tips you should give a caregiver for a pt
observe transfer and practice providing assistance
problem solve most effective way to use pt/family members abilities
encourage gradual independence and decreased assistance
prepare home environment to match the level of ability of the pt/family member prior to discharge
