Transfers Part 1 Flashcards
What is a transfer?
Moving from one position or surface to another position or surface
What are common types of transfers?
- Sit to stand
- Stand to sit
- Car transfer
- Toilet transfer
- Stand pivot
- Squat pivot
- Slide-board transfer
What are some patient considerations you should note before transferring?
- Strength
- Joint mobility
- Balance
- Pain level
- Cognition
- Endurance
- Motor control
- Spasticity
- Precautions
What are some equipment considerations you should note before transferring?
- Are assistive devices necessary?
- Is the wheelchair locked
- Do you have a gaitbelt
What are some environment considerations you should note before transferring?
- Do you have the space to transfer?
- Are there hazards in the environment?
- Do you have to move a certain direction?
What are some patient experience considerations you should note before transferring?
- Have they done this before?
- If they have, how much help did they need?
- Does the patient regularly use any type of device or orthotics?
You should always have a _____ and a _____ for your transfer.
Purpose and a goal
What are some safety considerations (surrounding specifically the gait belt) you should note before transferring?
- Gait belts should be used for most transfers
- Exceptions include patients who are independent who do not have balance impairments
- Worn on the waist, but can be placed higher as needed
- Grip: lumbrical grip
- Should be snug but not uncomfortable
Why do we use gaitbelts?
Improves the safety for patients and for the caregiver
If the patient has a chest tube, PEG tube, or an iliostomy/ colostomy bag, where should your gait belt go?
Above
What are some line and tube considerations you should note before transferring?
- Keep them organized
- Know which lines are critical
- Know which lines can be removed
- Move towards the shortest line
- Rearrange the environment to accommodate the line
- Use extension and portable lines when possible
What should you NEVER do in regards to lines?
NEVER step over a line
Patients in the ICU frequently have more than _____ lines.
10
Patients on the floor may have _____ to _____ lines (sometimes more?
1 to 5
What are some common types of lines? (this is a big long list of lines)
- Nasogastric tubes
- Heart rate monitors
- Central lines
- Endotracheal tubes
- O2 monitors
- Sequential compression devices
- Arterial lines
- Urinary catheters
- Chest tubes
- Blood pressure cuffs
- Rectal tubes
- IV lines
- Nasal cannulas
- Drains
If the environment is not set up for you to complete your mobility task what should you do?
Rearrange the furniture and get the equipment you need BEFORE moving the patient
Good body mechanics help you to do what?
- Use less energy
- Reduce stain on the body tissue
- Produce safe, efficient movement
- Promote control and balance
What are some key principles for transfers?
- Use physics to your advantage
- Keep the patient safe
- Consider your environment
- Teach/ cue the transfer if needed
- Mental preparation
- Guard patient where you do not impeded movement, but can still keep them safe
- Consider patient positioning pre and post transfer
- Is the surface stable/ safe
- Is this more functional or accessible for the patient?
How should you guard a patient?
- Stand where you so not impeded movement
- Promote safety (do not under guard)
- Promote function (do not over guard)
- Use a gaitbelt
- Support/ block limbs with strength deficits
- Position yourself and the patient for efficient movement
What side should you stand on during a transfer?
Stand on the patients more affected side (if there is one)
How would you document the subjective of a transfer?
“Patient reports wanting to independently transfer from wheelchair to bed at the end of a long day”
How would you document the objective of a transfer?
“Completed a level height squat pivot transfer to the right from the wheelchair to the bed requiring partial assist or ModA from the patient. Gait belt use throughout session.”
How would you document the assessment of a transfer?
“Patient requires further skilled therapy intervention due to requiring assistance as well as verbal and tactile cues for efficient mechanics and safety during transfers.”
How would you document the plan of a transfer?
“Practice similar transfers with less assistance, higher repetitions, and/ or uneven surfaces next session.”
What are the mechanics of a sit to stand?
- Patient should be on the edge of the chair
- Feet should be underneath them
- They should lean forward to stand
How should you guard for a sit to stand?
From the side or from the front
What can influence a therapist decision on where to guard?
- Level os assistance
- Precautions
- Space
- Assistive devices
- Affected or Unaffected side
- Your mechanics
What is a stand pivot transfer?
- Stand all the way up, turn and sit in an adjacent surface
- Can be done with our without an assistive device
When is it good to use a stand pivot?
- When there is something obstructing a squat pivot (like a wheelchair arm rest)
- The patient is capable of standing with or without assistance
- The transfer is to a different height surface
How should you guard for a stand pivot?
From the side or from the front
What is a squat pivot?
- Staying in a squatted position, turn and sit in an adjacent surface
- Can be done with out without an assistive device
When is a squat pivot good to use?
- When there is nothing obstructing the path to the other surface
- The patient is not capable of standing
- The transfer is to a relatively similar height surface (but not always)
What are the mechanics for a squat pivot transfer?
- Head hip relationship
- Seesaw concept
- Your feet and their feet on the ground are the fulcrum
- They lean forward and shift toward you while you drop your hips during transfer
- You must stay at balance point
- You lift hips and they shift weight back to sit
How should you guard for a squat pivot?
In the front
