Transfers

Question 1

transfer

Answer 1

safe movement of a person from one surface, location, or position to another; often one of the first forms of mobility someone might practice following a surgery, stroke, etc.

Question 2

Transfer activities

Answer 2

wheelchair to bed (vice versa), bed to bedside chair
chair to floor
floor to stand
bed to stretcher
chair to specialty equipment (stander, etc)
car transfer
toilet transfer
tub transfer

Question 3

why mobility activities and transfers?

Answer 3

prevents skin problems, weakness, and contractures, acts as a stepping stone to independent movement, promotes function

Question 4

independent transfer

Answer 4

patient can do a transfer without any assistance from another person or the use of an assistive device

Question 5

modified independent transfer

Answer 5

a client either needs an assistive device or an extended amount of time to complete the transfer

Question 6

Assisted

Answer 6

needs hands on assist from another person

Question 7

Standby (supervision assistance)

Answer 7

client needs somebody with them (next to or supervising) but helper is not actually touching the client

Question 8

Contact guard

Answer 8

light touch for steadying by therapist

Question 9

minimal assist

Answer 9

client completes 75-99% of task, helper completes 1-25% of task

Question 10

moderate assist

Answer 10

patient completes 50-74% of task, helper completes 26-50% of task

Question 11

maximal assist

Answer 11

patient completes 25-49% of task, helper completes 51-75% of task

Question 12

Dependent/total assist

Answer 12

patient completes <25% of task, helper completes >75% of task

Question 13

Transfer equipment and devices

Answer 13

bedrail, gait belt, over-the-bed or trapeze bar, transfer board, manual or electrical lift

Question 14

Four general parameters for determining appropriate transfer

Answer 14

your evaluation, including patient experience and physical ability, goals of treatment, information from the patient and family, and medical record information available (like meds and side effects, diagnoses, lab values, etc)

Question 15

required documentation

Answer 15

type of transfer, surfaces transferred to and from (height as well), amount of time to complete transfer, level of safety demonstrated (impulsive, careful, etc), level of consistency of performance, equipment or devices used

Question 16

Before the transfer

Answer 16

analyze transfer into component parts (position of equipment, operator of equipment, position of patient’s body, movements required), prepare patient (physically & mentally), prepare the environment, prepare yourself and other persons involved

Question 17

preparing for transfer checklist

Answer 17

• hand sanitize
• informed consent
• demonstrate transfer and ask patient to repeat it back
• don safety belt
• position wheelchair
• ensure bed and wheelchair brakes are engaged
• remove foot rests
• check caster wheels
• patient scoots forward
• remove arm rest if needed
• remain close to and guard patient properly

Question 18

types of transfers:

Standing

Answer 18

• independent pivot
• modified independent
• standby pivot
• assisted pivot with walker
• assisted pivot
• dependent pivot

Question 19

types of transfers:

Sitting

Answer 19

• independent transfer
• lateral assisted transfer
• sliding board transfer
• one person dependent lift (sitting dependent lift)
• two person dependent lift
• Hoyer lift

Question 20

conditions requiring special precautions:

Total hip replacement

Answer 20

avoid hip flexion past 90 degrees, avoid internal rotation of hip, avoid hip adduction past midline

Question 21

conditions requiring special precautions:

Non-weight bearing on one leg

Answer 21

therapist guards the unaffected leg, therapist must stand on the affected side when completing gait training

Question 22

conditions requiring special precautions:

Back trauma, pain or surgery

Answer 22

Avoid BLT (bending, lifting, twisting), therapist teaches log roll technique for bed mobility

Question 23

conditions requiring special precautions:

Spinal cord injury

Answer 23

• these types of patients have very weak trunks and do not have the sitting balance of a typical client, lower extremities may be weak as well, bones are weaker as of osteopenia
• Ensure you maintain contact with the patient’s trunk at all times when they are sitting without support, stand in front of the person and be ready to block their knees so their buttocks doesn’t slide from surface, be mindful of the positioning of the lower and upper extremities during transfer to avoid injury

Question 24

conditions requiring special precautions:

Burns

Answer 24

Avoid shearing forces during transfers (on burns or graft sites), avoid direct pressure over wounds and graft sites

Question 25

conditions requiring special precautions:

Hemiplegia

Answer 25

• may be experienced after a stroke, brain injury, or other neurologic conditions
• make sure you are considering the patient’s weak arm and leg, guard the affected leg by blocking the knee, transfer in the direction of the patient’s strong side, never try to stabilize the person by holding onto their hemiplegic arm (can cause injury to the shoulder)