Transfers Flashcards
questions to ask when determining whether to use a mechanical or manual transfer
what is your objective?
how dependent are they?
rehab potential
what is your purpose: teaching or moving?
types of assistance
verbal instruction verbal commands verbal cuing tactile cuing/balance control physical assistance
verbal instruction
explanation
verbal commands
“stand, sit, turn”; “lift, shift, lower”
tactile cuing/balance control
tapping what you want to move
physical assistance
partial vs. max
how to prepare for the transfer
review medical record and interview patient
know your objective
know patient’s abilities and limitations
take into account muscle strength, ROM, flexibility, balance, endurance, mental status
gather necessary equipment or personnel (plan ahead)
clear the space
consider hair, watches, jewelry, etc.
how to engage with your patient before a transfer
introduce yourself; explain plan
instruct
demo, repeat back, questions
when is a transfer complete?
the patient is draped
the patient feels secure in new position
patient has a way to call for assistance
what is the purpose of a gait belt?
used to provide stability and support as something to hold on to
gait belt precautions
not for the independent patient
uncomfortable and restrictive if too tight
can slide causing scrapes and skin tears
should have a layer of clothing between skin and belt
can interfere with tubes, lines, and surgical sites
if used well, safety positives of a gait belt far outweigh potential negatives
true
your patient has a surgical incision on the abdomen, where should you place the gait belt?
above the surgical incision
safety guidelines for transfers
proper footwear; no sock feet
do not leave an unsafe patient unguarded or unattended
what should your patient be wearing before a transfer?
shoes or grippy socks
who is considered an unsafe patient?
physically or cognitively impaired
sliding board transfer considerations to and from WC
appropriate length of board no bare skin on board WC level with bed or mat WC angled next to bed apply locks remove near armrest
sliding board hand placement
do not allow patient to grip handle or end of board
be sure the patient moves the leading hand out before moving the hips up and over
in general, where should you guard from?
the front
can you guard from behind?
if the patient is independent
when performing an assisted transfer you need
reliable WB on at least on LE
during a pivot transfer the patient
bears weight on at least one LE and pivots to another surface
during a squat pivot
the patient achieves a partial standing position–enough to clear the seat and/or armrest
during a standing pivot the patient…
the patient achieves an upright posture before pivoting and sitting
when assisting with a pivot transfer to a WC…
determine direction position WC patient scoots forward patient's foot placement patient leans forward patient's hand placement block knees grip gait belt "1, 2, 3" lift (lean posteriorly) shift, and lower
when is a seated transfer appropriate?
pt. with a SCI
low center of mass
THA transfer precautions
avoid excessive hip flexion, adduction, IR
transfer away from the involved side
THA transfer precautions
avoid excessive hip flexion, adduction, IR
transferring away from the involved side places the patient at higher risk for dislocation
hemiplegia transfer precautions
do not pull on the weak side
consider possible one-sided neglect
transferring toward the strong side is typically easier
s/p spinal surgery transfer precautions
avoid trunk rotation
