Moving and Handling

Arega Arutiunian NVQ level 2 – Moving and Handling . How to Transfer a Weak Patient from Bed to Chair/Wheelchair . Lying in bed for a long period of time is generally depressing and boring for most patients. Being transferred on a chair enables the patient to execute some slight movements that is beneficial in improving circulation. As for being transferred on a wheelchair, it serves as a way to transport a weak patient on hospital areas , to the bathroom or in the lounge room . First i must inform the patient about the procedure. If the patient wants to be transferred on a chair, i will explain the details .

And if there is a need for him to be transferred on a wheelchair, i need to explain the purpose and destination of the transfer. Using a nice tone of voice and right body language. Informing the patient will facilitate cooperation and will make him feel that he is being respected rather than being controlled. Position the chair or wheelchair next to the bed facing the foot of the bed. I need to bring the chair as close as possible to reduce the distance of the transfer. If a wheelchair is used, i will make sure to lock its brake and fold the foot rests, as soon as my position it near the bed.

I need to adjust the height of the bed in its lowest position-this way it will be easy for the patient to step down on the floor, thus, decreasing the risk of injury from falling. I will lock the brake of the bed and then assist the patient in doing side lying position, facing the direction of the transfer. I need to lace one arm under the shoulder of the patient and the other arm supporting the patients’ thigh on the opposite side. Count to three and then carefully swing the legs of the patient over the side of the bed and assist him in lifting his trunk and shoulders until he is in sitting position.

If patient is strong enough to do some movements, i can allow the patient to participate on the manoeuvre. I will ask patient to use the leg on the outer side of the bed to scoop the leg on the other side. Than carefully swing both his legs on the side of the bed and then assist him in lifting his trunk and shoulders until he is in sitting position. Place my arms around the torso of the patient for support. Put one arm of the patient over my shoulder -while his other arm is extended on the bed, to help support the position.

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Instruct the patient to scoot over the edge of the bed until feet is flat on the floor. Widen the distance of my feet, with right foot forward, and the left foot back for an easy shift of my weight as i lift the patient. Maintain the position above, with my arms still supporting the torso of the patient. One arm of the patient should still be on my shoulder and his other arm should still be extended on the bed (palm flat on bed). Slightly bend my knees and lean my body. Then i will instruct the patient to get ready for a push from one arm that’s extended on the bed, as i lift him up to standing position.

Count to three as i assist the patient to standing position and he is pushing off from at the same time. Need to raise patient to standing position and keep my back straight. Pivot the patient so that his back is positioned in front of the chair or wheelchair- i need to instruct him to grasp on the armrest for additional support, and then slowly assist the patient as he lowers himself on the seat of the chair. Help the patient in positioning himself properly when seated. I need to make sure that his buttocks are entirely rested on the seat and his back firmly resting on the back support.

When in a wheelchair, i should place his arms on the armrests and his feet on the footrests. How to Use a Hoyer Lift to Transfer a Patient A Hoyer Lift is a lifting device or hydraulic lift that is commonly used in nursing homes and other medical facilities to help transfer patients from beds to wheelchairs and back again. Special care and attention needs to be used when transferring any patient using a Hoyer Lift, as injuries and even death may result from improper techniques or use of the lift. Position the sling that comes with the Hoyer Lift beneath the patient to be transferred.

In some cases, caregivers will be required to carefully roll the patient from side to side in order to position the sling properly. I need to make sure that the sling is evenly distributed, without wrinkles and is correctly positioned, the seam side of the sling away from the skin of the patient. Need to move the Hoyer Lift so that the extended legs slide under the bed. The legs of the Hoyer Lift are able to open and close to facilitate wheelchairs. I should slide the Hoyer legs under the bed until the swivel bar hook of the lift is directly over the patient’s abdomen. Attach the einforced “O” rings in the sling straps that have been placed around the patient’s legs first, connecting to the “S” hooks of the Hoyer Lift first. Need to make sure that the leg straps (if two are present) are positioned to prevent the patient from slipping out of the sling. Should point the tips of the “S” hooks away from the patient’s face for extra safety. Need to attach the shortest web strap through the hole for the back and head support part of the sling, which will help make sure the patient will have neck and head support when lifted. Then, i must attach the web  straps to the swivel bar.

Press the button that will engage the lift and slowly lift the patient, maintaining control of both the sling and the lift. The Hoyer Lift should always be used with two people. One person should be helping control movement of the patient while the other operates the lifting mechanism and opens the legs of the lift for optimal stability. One person should always maintain control of the patient in the sling while the second person operates the lift. Once the patient is centred over a wheelchair or bed, lower the lift and then reverse the process used to place the sling .

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