Which piece of equipment can you use to help move a client who can assist with moving up in bed?

Follow these steps to move a patient from bed to a wheelchair. The technique below assumes the patient can stand on at least one leg.

If the patient cannot use at least one leg, you will need to use a lift to transfer the patient.

Think through the steps before you act and get help if you need it. If you are not able to support the patient by yourself, you could injure yourself and the patient.

Make sure any loose rugs are out of the way to prevent slipping. You may want to put non-skid socks or shoes on the patient's feet if the patient needs to step onto a slippery surface.

The following steps should be followed:

• Explain the steps to the patient.
• Park the wheelchair next to the bed, close to you.
• Put the brakes on and move the footrests out of the way.

Before transferring into the wheelchair, the patient must be sitting.

Allow the patient to sit for a few moments, in case the patient feels dizzy when first sitting up.

The following steps should be followed when getting ready to transfer a patient:

• To get the patient into a seated position, roll the patient onto the same side as the wheelchair.
• Put one of your arms under the patient's shoulders and one behind the knees. Bend your knees.
• Swing the patient's feet off the edge of the bed and use the momentum to help the patient into a sitting position.
• Move the patient to the edge of the bed and lower the bed so the patient's feet are touching the ground.

If you have a gait belt, place it on the patient to help you get a grip during the transfer. During the turn, the patient can either hold onto you or reach for the wheelchair. They should not wrap their arms around your head or neck.

Stand as close as you can to the patient, reach around the chest, and lock your hands behind the patient or grab the gait belt.

The following steps should be followed:

• Place the patient's outside leg (the one farthest from the wheelchair) between your knees for support. Bend your knees and keep your back straight.
• Count to three and slowly stand up. Use your legs to lift.
• At the same time, the patient should place their hands by their sides and help push off the bed.
• The patient should help support their weight on their good leg during the transfer.
• Pivot towards the wheelchair, moving your feet so your back is aligned with your hips.
• Once the patient's legs are touching the seat of the wheelchair, bend your knees to lower the patient into the seat. At the same time, ask the patient to reach for the wheelchair armrest.

If the patient starts to fall during the transfer, lower the person to the nearest flat surface, bed, chair or floor.

Pivot turn; Transfer from bed to wheelchair

American Red Cross. Assisting with positioning and transferring. In: American Red Cross. American Red Cross Nurse Assistant Training Textbook. 4th ed. American National Red Cross; 2018:chap 11.

Bergman R, De Jesus O. Patient care transfer techniques. [Updated 2021 Oct 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK564305.

Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Body mechanics and positioning. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2017:chap 12.

Timby BK. Assisting the inactive client. In: Timby BK, ed. Fundamentals of nursing skills and concepts. 11th ed. Philadelphia, PA: Wolters Kluwer Health: Lippincott Williams & Wilkens; 2017:unit 6.

Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Chapter 3. Safer Patient Handling, Positioning, Transfers and Ambulation

An assistive device is an object or piece of equipment designed to help a patient with activities of daily living, such as a walker, cane, gait belt, or mechanical lift (WHO, 2018). Assistive devices also allow the the healthcare worker to transfer and move patients in a way that reduces risk for injury to themselves and patients. Table 3.4 lists some assistive devices found in the hospital and community settings that can be used to help transfer patients in and out of bed and within the bed.

Table 3.4 Assistive Devices to Help Transfer Patients In and Out of Bed and Within the Bed
Type	Definition
Gait belt or transfer belt	Used to ensure a good grip on potentially unstable patients. The device provides added stability when transferring patients. It is a 5 mm (2 in) wide belt, with or without handles, that is placed around a patient’s waist and fastened with Velcro. The gait belt must always be applied on top of clothing or gown to protect the patient’s skin. A gait belt can be used with patients in both one-person or two-person pivot transfer, or in transfer with a slider board. Gait belt
Slider board (stretcher board)	Slider board (red) on a stretcher Placing a slider board (transfer board) under a patient A slider board is used to transfer immobile patients from one surface to another while the patient is lying supine. The board assists healthcare providers move immobile, bariatric, or complex patients more safely.
Mechanical lift	A mechanical lift is a hydraulic lift, usually attached to a ceiling, used to move patients who cannot bear weight, who are unpredictable or unreliable, or who have a medical condition that does not allow them to stand or assist with moving. Mechanical lift
Air transfer mattress	Using air assisted technology, air transfer mattresses allow caregivers to easily reposition and transfer patients laterally (i.e., bed to stretcher and vice versa). See: Product information for HoverMatt Air Transfer System.
Slider sheets	Nylon sheets used under the patient. Sometimes the nylon is the undersurface of the transfer sheet. Sometimes a combination of a transfer sheet’s nylon surface in contact with a nylon surface fitted bed sheet can help to reduce friction during patient moves in bed. Figure 3.3 Slider sheet / turning sheet
Monkey bar (a.k.a., medical trapeze)	A trapeze positioned above the patient near the head of the bed allows the patient to grasp and reposition themselves or to help with re-positioning. The trapeze can be fixed to the bed or free standing. They are contraindicated in some situations including new spinal cord injury, post abdominal surgery, and shoulder conditions. Figure 3.4 bed trapeze / monkey bar
Sit to stand lift	Device used to assist patients from a sitting to standing position. Figure 3.5 Sit to stand mechanical lift
Transfer board	Transfer boards (not to be confused with a slider or stretcher board) are small pieces of rigid wood or plastic used to bridge the gap between two surfaces. For example, between a wheelchair and a bed. When a patient is initially learning to use a transfer board, one to two healthcare workers may use a gait belt to assist. Eventually some patients are able to transfer independently from a wheelchair to bed using a transfer board. Figure 3.6 Slider board for transferring bed to chair and vice versa
Data sources: HoverTech International, 2016; Perry et al., 2018.

Special considerations:

• Use assistive devices only if properly trained in their safe use.
• Always tell patients what you are about to do, and how they should assist you in the procedure.
• Always perform a patient risk assessment or mobility assessment prior to using any assistive devices. The Assessing Risks web page from WorkSafeBC provides additional information regarding assessing risk and resources to help with decisions around safe patient handling.
• Use proper body mechanics when using assistive devices to reduce risk of injury.

Critical Thinking Exercise

1. A 100 kg patient with limited mobility requires transfer from his bed to stretcher. The nurse chooses to use a HoverMatt© air transfer mattress for the transfer. Describe how this technology limits musculoskeletal strain, and give the steps for its use in this situation.

Which piece of equipment can you use to help move a person who can assist with moving up in bed?

What other equipment should you use when moving a patient from bed to bed?

What types of equipment might you use to move a patient?

What type of equipment is used by patients for mobility?