Transfers

Question 1

questions to ask when determining whether to use a mechanical or manual transfer

Answer 1

what is your objective?
how dependent are they?
rehab potential
what is your purpose: teaching or moving?

Question 2

types of assistance

Answer 2

verbal instruction
verbal commands
verbal cuing
tactile cuing/balance control
physical assistance

Question 3

verbal instruction

Answer 3

explanation

Question 4

verbal commands

Answer 4

“stand, sit, turn”; “lift, shift, lower”

Question 5

tactile cuing/balance control

Answer 5

tapping what you want to move

Question 6

physical assistance

Answer 6

partial vs. max

Question 7

how to prepare for the transfer

Answer 7

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.

Question 8

how to engage with your patient before a transfer

Answer 8

introduce yourself; explain plan

Question 9

instruct

Answer 9

demo, repeat back, questions

Question 10

when is a transfer complete?

Answer 10

the patient is draped
the patient feels secure in new position
patient has a way to call for assistance

Question 11

what is the purpose of a gait belt?

Answer 11

used to provide stability and support as something to hold on to

Question 12

gait belt precautions

Answer 12

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

Question 13

if used well, safety positives of a gait belt far outweigh potential negatives

Answer 13

true

Question 14

your patient has a surgical incision on the abdomen, where should you place the gait belt?

Answer 14

above the surgical incision

Question 15

safety guidelines for transfers

Answer 15

proper footwear; no sock feet

do not leave an unsafe patient unguarded or unattended

Question 16

what should your patient be wearing before a transfer?

Answer 16

shoes or grippy socks

Question 17

who is considered an unsafe patient?

Answer 17

physically or cognitively impaired

Question 18

sliding board transfer considerations to and from WC

Answer 18

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

Question 19

sliding board hand placement

Answer 19

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

Question 20

in general, where should you guard from?

Answer 20

the front

Question 21

can you guard from behind?

Answer 21

if the patient is independent

Question 22

when performing an assisted transfer you need

Answer 22

reliable WB on at least on LE

Question 23

during a pivot transfer the patient

Answer 23

bears weight on at least one LE and pivots to another surface

Question 24

during a squat pivot

Answer 24

the patient achieves a partial standing position–enough to clear the seat and/or armrest

Question 25

during a standing pivot the patient...

Answer 25

the patient achieves an upright posture before pivoting and sitting

Question 26

when assisting with a pivot transfer to a WC...

Answer 26

``` 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 ```

Question 27

when is a seated transfer appropriate?

Answer 27

pt. with a SCI | low center of mass

Question 28

THA transfer precautions

Answer 28

avoid excessive hip flexion, adduction, IR | transfer away from the involved side

Question 29

THA transfer precautions

Answer 29

avoid excessive hip flexion, adduction, IR | transferring away from the involved side places the patient at higher risk for dislocation

Question 30

hemiplegia transfer precautions

Answer 30

do not pull on the weak side consider possible one-sided neglect transferring toward the strong side is typically easier

Question 31

s/p spinal surgery transfer precautions

Answer 31

avoid trunk rotation