Presented by: Sana’a AL-Sulami

At the end of this lecture each student should be able to: 1 - Define transferring. 2- Enumerate the reasons of moving & transferring. 3- Know the methods of transferring. 4- Realize the nursing consideration for transferring the patient. 5- Demonstrate and understand the general and specific procedures of moving and transferring.

Definition of transferring  Moving a patient from place refer to moving a patient from bed to a chair or stretcher, or wheelchair with maximum comfort and safety for patient and nurse.

Reasons for transferring  Improvement of the patient’s condition (from ICU to medicine unit.  Worsens of patient’s condition ( to ICU)  The need for surgery or X ray  Transfers at the patient’s request

Reasons for moving  Change position  Repositioning the client  Client’s slid down in bed from fowler’s position  Changing the bed linen

Methods of transferring  By wheel l chair  By stretcher  By a movable bed

1. Assess:  The client’s physical abilities  Ability to understand instructions  Degree of comfort or discomfort when moving  Client’s weight  Presence of orthostatic hypotension  Your own strength and ability to move the client

 2. If indicated, use pain relief modalities or medication prior to moving the client  3. Prepare supportive equipment (pillows)  4. Obtain required assistance  5. Explain the procedure to the client and listen to any suggestions the client  6. Provide privacy

 Wash hands  Raise the height of the bed to bring the client close to your center of gravity  Lock the wheels on the bed and raise the rail on the side of the bed opposite you to ensure client safety  10. Face in the direction of the movement to prevent spinal twisting

Transferring between bed and chair Purpose The client assumes a sitting position on the edge of the bed before walking, moving to a chair, eating, or performing other activities Equipment Robe or appropriate clothing and shoes with nonskid soles Transfer (walking) belt Chair, wheelchair

Procedure: Ask the client to: ◦Move forward and sit on the edge of the bed ◦Lean forward slightly from the hips. ◦Place the client’s hands on the bed surface or on your shoulders. ◦The client should not grasp your neck for support Position yourself correctly. Encircle the client’s waist with your arms, and grasp the transfer belt at the client’s back with thumbs pointing downward

Procedure: Assist the client to stand, and then move together toward the wheelchair On the count of three, ask the client to push with the back foot, rock to the forward foot, and extend (straighten) the joints of her lower extremities. Support the client in an upright standing position for a few moments. Together, pivot or take a few steps toward the wheelchair.

Procedure: Assist the client to sit. Ask the client to: ◦Back up to the wheelchair and place the legs against the seat ◦Place the foot of the stronger leg slightly behind the other ◦Keep the other foot forward ◦Place both hands on the wheelchair arms or on your shoulders Ensure client safety. Documentation.

 Lower the head of the bed until it is flat.  Raise the bed so that it is slightly higher than the surface of the stretcher.  Ensure that the wheels on the bed are locked.  Pull the draw sheet out from both sides of the bed.  Move the client to the edge of the bed, and position the stretcher.  Transfer the client securely to the stretcher ensure client comfort and safety

Stand beside the client’s hips, and face the far corner of the bottom of the bed. Assume a broad stance, placing the foot nearest the client forward. Lean your trunk forward from the hips. Flex your hips, knees, and ankles. Move the client to a sitting position. Assess vital signs as indicated by the client’s health status Document all relevant information

 Position yourself appropriately and move the client.  face the direction of movement  flex hips, knee,  place your near arm under the client’s thighs shift your weight to the front leg as the client  pushes with the heels and pulls with the arms so that the client moves toward the head of the bed.  Elevate the head of the bed and provide appropriate support devices for the client ’s new position  Document all relevant information.

Logrolling a Client Purpose ◦To turn a client whose body most all times be kept in straight alignment. Procedure : Pull the client to the side of the bed. Move to the other side of the bed, and place supportive devices for the client when turned Roll and position the client in proper alignment.

Procedure: Using a Turn or Lift Sheet Use a turn sheet to facilitate logrolling. First, stand with another nurse on the same side of the bed. Assume a broad stance with one foot forward, and grasp half of the fan folded or rolled edge of the turn sheet. On a signal, pull the client toward both of you. Document all relevant information.