Important Considerations for Patient Transfers

    There are several things healthcare professionals need to consider for an efficient transfer, or movement of a client from one surface to another, to ensure safety for everyone involved. A transfer can include a bed, tub, shower, vehicle, toilet, chair or the floor. The practitioner should thoroughly explain the steps and the client’s role before initiating the transfer. 

    First, a therapist would need to consider their client’s capabilities and medical precautions. This includes their balance, cognition, strength, endurance, body type, wheelchair style, ROM, medical instruments, and orthotics and prosthetics. Medical instruments can include a catheter bag or IV tubes. 

    Second, the therapist should consider their own capabilities, preparations, and positioning. How does one’s body size compare to their client’s? What are their physical capabilities? Do they need to ask for assistance to complete the transfer? Are they practicing safe body mechanics like staying to the front or side of the client while staying as close as possible to them, maintaining a wide base of support, and refraining from twisting their trunk as they transfer? They should use key points of control and use their own body to facilitate client stability and proper body mechanics. 

    Third, the therapist should definitely consider the environment and make sure they have all the tools needed for a safe, effective transfer. They may need a gait belt or sliding board readily available. Additionally, one will want to make sure gaps are closed, wheelchair brakes are engaged, footrests are removed and out of the way, and the castor wheels are turned and out of the way, too.

    Next, the client’s positioning is important to consider. Healthy body mechanics are important for them to use for their safety as well as the therapist’s. They also should not, under any circumstances, grab onto or place their arms around the practitioner’s neck for any reason. This is unsafe and will result in injury most times if not always.  A smaller base of support is better for mobility purposes so the client should be positioned in a way that will make it easier for them to move from one surface to another. Transferring on the client’s unaffected side and pointing their heel in the direction they’ll be going are also key components. They should also be at the edge of the surface and shift their center of gravity forward to begin the transfer. 

    Lastly, the positioning of all equipment is important to note. This can include a wheelchair, walker, sliding board, bed, etc. Wheelchairs should be placed perpendicular to the transfer surface and the armrest on the transfer side should be removed for a lateral swing and/or sliding board transfer. Gait belts should be placed tightly (but comfortably) around a client’s waist or under the breasts or underarms depending on their needs. A sliding board should be positioned with one end under the buttocks and the other end on the transfer surface with no gap between the chair and surface (Weisser-Pike, 2023). 

    It is the role of Occupational Therapists and other healthcare professionals to remain knowledgeable about protocols, safety measures, and what is best overall for their clients.

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References 

Weisser-Pike, O. (2023) Lecture 10: Bed mobility & transfers [PowerPoint Slides]. Blackboard.