Moving Patients from Bed to Wheelchair
| Using a transfer belt can help make moving patients safer. |
Patient safety is often the main concern when moving patients from bed. But remember not to lift at the expense of your own back. This transfer often requires the patient's help, so clear communication is essential. If the patient can’t help much, you’ll need two peopl or a fully body sling lift.
Remember: When patients are weak, brace your knees against theirs to keep their legs from buckling. Also, transfer toward patient’s stronger side if possible.
Step 1. Sit the patient up
- Position and lock the wheelchair close to the bed. Remove the armrest nearest to the bed, and swing away both leg rests.
- Help the patient turn onto his or her side, facing the wheelchair.
- Put an arm under the patient’s neck with your hand supporting the shoulder blade; put your other hand under the knees.
- Swing the patient's legs over the edge of the bed, helping the patient to sit up.
Step 2. Stand the patient up
- Have the patient scoot to the edge of the bed.
- Assist the patient in putting on skid proof socks or shoes.
- Put your arms around the patient’s chest, and clasp your hands behind his or her back. Or, you may also use a transfer belt to provide a firm handhold.
- Supporting the leg farthest from the wheelchair between your legs, lean back, shift your weight, and lift.
Step 3. Pivot toward chair
- Have the patient pivot toward the chair, as you continue to clasp your hands around the patient.
- A helper can support the wheelchair or patient from behind.
Step 4. Sit the patient down
- As the patient bends toward you, bend your knees and lower the patient into the back of the wheelchair.
- A helper may position the patient’s buttocks and support the chair.
- Reposition the foot rests and the patient's feet.
StayWell last reviewed this educational content on 3/1/2018
© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.
IMPORTANT:
Be sure the fire exit doors are kept closed at all times so smoke cannot enter the stairway.
These exits are not to be used for any type of storage. They must remain clear and well lighted at all times. If at anytime, you observe fire exit doors being tied or propped open, please report it to the Department of Environmental Health & Safety.
In buildings where immediate building evacuation is not required, patient, visitor, employee, and staff evacuation shall be initiated only when a danger due to fire or smoke has been identified or code red confirmed has been announced in their area.
If evacuation is required, it shall be conducted per the following guidelines:
- Horizontal Evacuation - Horizontal evacuation is preferred over vertical evacuation. Patients will be moved to an adjacent safe smoke compartment on the same floor, away from the Fire Scene.
- Vertical Evacuation - Only if necessary and as directed, patients will be moved to another floor - typically a floor below the Fire Scene. If evacuation to a lower floor becomes necessary, use of the elevators will be coordinated with the PFD based on the location of the fire and the amount of smoke in the area of the elevators.
- Complete Patient Evacuation - Should the emergency condition be of a severity such that the building is endangered, and cannot continue to be occupied, a complete evacuation shall be initiated. Directions given to evacuate the building by the PFD Incident Commander shall be carried out in an orderly fashion to ensure that the patient care is not compromised due to the evacuation. Patient receiving locations shall be coordinated with the Hospital Incident Command structure.
Introduction[edit | edit source]
The wheelchair service provision process is not simply assessment followed by prescription; but providing a client with an appropriate wheelchair. [1] Wheelchair preparation is the Step number five, as per the eight steps of wheelchair service delivery, described in the WHO guidelines on the provision of manual wheelchairs in less resourced settings. [2]
The objective of good practice in product preparation is to prepare the wheelchair for the fitting, including modifications or custom postural support component. [3]
Once the equipment is received, the wheelchair base/frame, accessories, and seating and positioning components should be assembled and set-up according to the preliminary specifications detailed in the recommendation and selection process. [1] This includes fabrication and installation of custom items and assessment of the function and operation of all mechanical components.
Wheelchair Preparation Includes[edit | edit source]
- Preparing the wheelchair to match the wheelchair user’s prescription (selection);
- Checking the wheelchair to make sure that it is safe and ready to be used and all parts are working properly. [4]
Good Practice in Product Preparation[edit | edit source]
- Each wheelchair being prepared is labeled with the user’s name and a serial number or barcode.
- Modifications to wheelchairs (permanently altering the frame or a component of the wheelchair) are carried out only by personnel with the appropriate knowledge and skills, since any such modification may have structural and functional implications.
- The production and installation of custom seating systems or individual postural support components should be carried out by personnel with the appropriate knowledge and skills. This work should also be done in close collaboration with the assessment personnel.
- All mobility equipments should be checked for quality and safety before the user tries it. [3]
Steps in Preparing the Wheelchair[edit | edit source]
Prepare the wheelchair in the following order: [4]
- Check that the wheelchair seat width and depth measurements are correct for the prescription (selection).
- Check that the cushion width and depth match the seat.
- Adjust (where possible)
- Backrest height and angle;
- Armrests height;
- Rear wheels position;
- Brakes position;
- Footrests height;
- Push handles height;
- Any other adjustments.
4. Carry out a “Wheelchair Safe and Ready” check.
Wheelchair Safe and Ready Checklist:[edit | edit source]
Use the checklist below to make sure that the wheelchair is safe to use and all parts are working. Always do this before the wheelchair user tries the wheelchair[4]
| For the Whole Wheelchair | How to Check | |
| There are no sharp edges | Check all over the wheelchair with eyes and hands | |
| No parts are damaged or scratched. | ||
| The wheelchair travels in a straight line | Push the wheelchair away from you, making sure the castor wheels are in the “trail” position. | |
| Front Castor Wheels | ||
| Spin freely. | Tip the wheelchair on to the back wheels. Spin the castor wheels. | |
| Spin without touching the fork. | ||
| Bolts are tight. | Check. They should feel firm. Do not over tighten. | |
| Front Castor Barrels | ||
| Castor fork spins freely. | Tip the wheelchair on to the back wheels. Spin the castor fork around. | |
| Rear Wheels | ||
| Spin freely. | Tip the wheelchair sideways on to one rear wheel. Spin the other wheel. Check the other side. | |
| Axle bolts are tight. | Check. They should feel firm. Do not over tighten. | |
| Tyres (if those are pneumatic) are inflated correctly. | Press on the tyres with your thumb. The wheel should depress a little, but no more than 5 mm. | |
| Push rims are secure | Check | |
| Brakes | ||
| Function properly | Apply brakes. Check the wheelchair cannot be moved. | |
| Footrests | ||
| Footrests are securely attached. | Check. | |
| Frame | ||
| Cross-folding wheelchair folds and unfolds easily. | Fold the wheelchair to check that the folding mechanisms are working correctly. | |
| Fold-down backrest – the backrest folds and unfolds easily. | ||
| Cushion | ||
| The cushion is in the cover correctly. | Usually the cushion cover is done up at the back of the cushion, underneath. | |
| The cushion is sitting on the wheelchair correctly. | If the cushion is contoured, the “well” for the seat bones should be at the back of the seat. | |
| The cushion cover fabric is tight but not too tight. | The cushion cover should not stretch tightly over any contours of the cushion. | |
| The cushion fully covers the seat | Check that no part of the seat is visible from under the cushion. This is particularly important for solid seats. |
Good Practice[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 Stan Arledge, William Armstrong, Mike Babinec,Brad E. Dicianno; Rehabilitation Engineering and Assistive Technology Society of North America,RESNA Wheelchair Service Provision Guide-2011..//www.resna.org/sites/default/files/legacy/resources/position-papers/RESNAWheelchairServiceProvisionGuide.pdf
- ↑ William Armstrong, Johan Borg, Marc Krizack, Alida Lindsley, Kylie Mines, Jon Pearlman, Kim Reisinger, Sarah Sheldon; Guidelines on the provision of Manual Wheelchairs in less resourced settings, WHO 2008 publication; Chapter No.3; Service Delivery; Page no.76 :Steps in service delivery.//www.who.int/disabilities/publications/technology/English%20Wheelchair%20Guidelines%20(EN%20for%20the%20web).pdf
- ↑ 3.0 3.1 William Armstrong, Johan Borg, Marc Krizack, Alida Lindsley, Kylie Mines, Jon Pearlman, Kim Reisinger, Sarah Sheldon, Guidelines on the provision of Manual Wheelchairs in less resourced settings - 2008 publication, Chapter No.3;Service delivery;Page No.82:Product preparation.//www.who.int/disabilities/publications/technology/English%20Wheelchair%20Guidelines%20(EN%20for%20the%20web).pdf
- ↑ 4.0 4.1 4.2 Sarah Frost, Kylie Mines, Jamie Noon, Elsje Scheffler, and Rebecca Jackson Stoeckle,World Health Organisation; Wheelchairervicetraining package; Reference Manual For Participants; Basic Level; - 2012 publication;Step 5 Product Wheelchair preparation; Page No.55,56//apps.who.int/iris/bitstream/handle/10665/78236/9789241503471_reference_manual_eng.pdf?sequence=1 .
- ↑ William Armstrong, Johan Borg, Marc Krizack, Alida Lindsley, Kylie Mines, Jon Pearlman, Kim Reisinger, Sarah Sheldon. Guidelines on the Provision of Manual Wheelchairs in Less Resourced Settings. World Health Organization; Geneva: 2008.
How to transport a patient in a wheelchair?
Transporting a patient in a wheelchair should be done with utmost care and safety. The patients using a wheelchair are usually fragile and uncomfortable. So, it’s the caretaker’s duty to see to the safety and stability of the patients while moving them in a wheelchair or transporting them from a wheelchair to any other spot.
What are the caretaker’s duties when transporting wheelchairs?
So, it’s the caretaker’s duty to see to the safety and stability of the patients while moving them in a wheelchair or transporting them from a wheelchair to any other spot. For wheelchair ridden patients or elder patients, special transport means like senior ambulance transport service will be used for safe transport.
What is special transport for elderly patients?
For wheelchair ridden patients or elder patients, special transport means like senior ambulance transport service will be used for safe transport. Explain the mode of operation of the wheelchair to the patients and make sure they understand them correctly. Make the wheelchair fit for smooth transfer.
How many caregivers are needed to put a patient in a wheelchair?
Two caregivers should see to the patient’s safety while putting them into a wheelchair. One should be in front of the patient and other should stand in the back to successfully lift the patient without any pain or irritation.
Which sequence is the correct order of actions to ensure safe transport using a wheelchair to prevent falls?
What is the correct order of actions to ensure safe transport using a wheelchair to prevent falls in a health care setting? When transferring a patient in a wheelchair, the nurse should first position the wheelchair on same side of the bed. The next step is to place a wedge cushion in the chair.
Which of the following should be one of the first steps in any patient transfer?
When preparing to move or position a patient, the nurse should first:.
Assemble adequate help to facilitate the change..
Assess the patient's ability to assist with the change..
Determine the effect of the patient's weight on the change..
Decide upon the most effective method to facilitate the change..
What is the correct order of steps for using belt restraints?
- Apply the belt over the patient's clothes, hospital gown, or pajamas. Smooth out wrinkles or creases in the patient's clothing. - Be sure to place the restraint at the waist, not the chest or the abdomen. - Bring the ties through the slots in the belt.
Which order of steps is correct for administering the times get up and go?
Begin by having the patient sit back in a standard arm chair and identify a line 3 meters, or 10 feet away, on the floor. 2 On the word “Go,” begin timing. 3 Stop timing after patient sits back down. 4 Record time.