Lab Guide 12

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Questions and Answers

What is the primary advantage of using a slippery sheet during patient transfers?

It reduces friction, facilitating easier lateral transfers. (correct)

It eliminates the need for multiple caregivers.

It allows the caregiver to lift the patient easily.

It provides a solid base for bridging gaps during transfers.

In which scenario should a transfer board be preferred over a slippery sheet?

When a caregiver is transferring a patient alone.

When the patient has no upper body strength.

When the patient can assist with the transfer due to some upper body control. (correct)

For moving a patient across a smaller distance.

Why is it necessary to have three caregivers for a lateral transfer in certain situations?

To provide emotional support to the patient.

If the patient is heavier, has limited control, or needs spinal precautions. (correct)

To ensure that the transfer is performed quickly.

To allow for more equipment to be utilized.

What should be the correct hand position for a caregiver during a lateral transfer?

Placing hands flat on the patient’s back to distribute pressure evenly. Signup and view all the answers

What is a common error that can occur during floor-to-chair transfers?

Neglecting to use clear communication among caregivers. Signup and view all the answers

Which patients are most appropriate for using a Hoyer lift?

Patients with severe weakness and unsteady balance Signup and view all the answers

What special consideration should be taken when using a Hoyer lift for a patient with THA?

The hip should remain in neutral or slightly abducted Signup and view all the answers

Why would a Hoyer lift not be recommended for a patient immediately s/p PSF?

Due to risk of spinal movement Signup and view all the answers

What does it mean to 'Complete the Transfer'?

To ensure the patient is securely positioned and access to necessities is provided Signup and view all the answers

In what scenario would you choose a transfer board over a slippery sheet?

When the transfer requires additional support Signup and view all the answers

When performing a lateral transfer, what hand position is most effective for the staff?

Hands should be at the patient's sides Signup and view all the answers

What might necessitate three people being involved in a lateral transfer?

The patient has difficulty following directions during the transfer Signup and view all the answers

What is a common error clinicians make during floor to chair transfers?

Not securing the patient properly before lifting Signup and view all the answers

What should caregivers focus on to ensure effective lateral transfers?

Maintaining an open and flat hand position on the patient's back Signup and view all the answers

Which factor is not a common reason for requiring three caregivers during a lateral transfer?

The patient is lightweight Signup and view all the answers

When performing a two-person vertical lift from a wheelchair to a bed, what is essential for reducing strain?

Positioning one person in front and one behind the patient Signup and view all the answers

What is a critical cue to provide during a chair-to-bed transfer?

Lean forward and reach toward the bed Signup and view all the answers

Which of the following is a key consideration to ensure safety during patient transfers?

Support the patient's weaker side adequately Signup and view all the answers

What should be avoided when moving a patient laterally to minimize injury?

Forward trunk leaning Signup and view all the answers

Which of the following strategies is recommended while performing a dependent lift transfer?

Ensuring the patient's hips are situated 1/3 from the head of the bed Signup and view all the answers

What is the best method to stabilize the trunk when transferring a patient across a wide surface?

Kneeling on the bed Signup and view all the answers

What is the primary role of the clinician positioned at the head of the patient during a transfer?

To guide the transfer and coordinate the movements Signup and view all the answers

Which patient consideration is essential for a safe lateral transfer?

Patient's capacity to bear weight through both legs Signup and view all the answers

What is the purpose of communicating with the patient before a transfer?

To prepare the patient and ensure they understand the steps involved Signup and view all the answers

How should the clinician's hands be positioned during a lateral transfer?

In a supinated power-grasp Signup and view all the answers

What is a recommended practice to ensure safety during lateral transfers?

Minimizing the height difference between transfer surfaces Signup and view all the answers

Which of the following is a key safety consideration when performing lateral transfers?

Using a slippery sheet to reduce friction Signup and view all the answers

What is a key factor to assess before initiating a dependent pivot transfer?

The level of strength and mobility the patient possesses Signup and view all the answers

In the context of patient transfers, what does the acronym AMAP/ANAP stand for?

As Much As Possible / As Needed Signup and view all the answers

What is an important consideration during a lateral transfer for a patient with THA?

Preventing any rotation of the sling and leg straps Signup and view all the answers

When using a Hoyer lift, what condition makes it particularly beneficial for patient transfers?

For patients who are non-weight bearing and completely dependent Signup and view all the answers

Which action should not be taken to complete a transfer effectively?

Remove transfer equipment quickly to avoid delays Signup and view all the answers

What does the log roll technique emphasize for a patient who has just undergone a PSF?

Maintaining spinal alignment while moving the patient Signup and view all the answers

What modification is necessary when opting to use a transfer board?

The patient must have some upper body strength and control Signup and view all the answers

Study Notes

Hoyer Lift Indications

A Hoyer lift is used for patients who are non-weight bearing, completely dependent, unable to assist with transfers, or have severe weakness, decreased mobility, paralysis, or unsteady balance
The lift is also helpful for those with high fall risks or requiring frequent transfers

Hoyer Lift for THA (Total Hip Arthroplasty)

Ensure the affected leg remains in neutral or slightly abducted, avoiding hip flexion beyond 90 degrees
Position the patient’s hips and knees in proper alignment, avoiding adduction or internal rotation.
Make sure the sling and leg straps are positioned to prevent rotation

Hoyer Lift for PSF (Posterior Spinal Fusion)

A Hoyer lift is generally not recommended immediately after PSF due to the risk of spinal movement.
Use a log roll technique or a slippery sheet with assistance to maintain spinal alignment and reduce strain on the spine.

Completing a Transfer

A transfer is complete when the patient is securely positioned and comfortable
Remove equipment, adjust positioning for support, and ensure access to necessities like call buttons, blankets, or other items

Slippery Sheet

A slippery sheet is used to reduce friction, making lateral transfers easier and less strenuous for both the patient and caregiver.
Other devices for this purpose are transfer boards, air-assisted transfer devices, and roller boards.

Transfer Board

Use a transfer board if a patient has some upper body strength and control allowing them to assist with the transfer.
A transfer board can also be used when bridging a larger gap between surfaces
The transfer board provides a solid base for the move.

Lateral Transfer Hand Positioning:

Keep hands open and flat on the patient’s back or support surfaces for an even distribution of pressure and to maintain control.

Lateral Transfers with Three People:

Use three people if the patient is heavier, has limited control, or requires strict spinal precautions.
This ensures the patient can be moved smoothly and with minimal strain on caregivers.

Two-Person Vertical Lift from Wheelchair to Bed:

One person is positioned behind the patient, supporting the torso and shoulders
The other person stands in front, supporting the legs or under the knees.
The patient should be in a semi-seated position to avoid strain on the back.

Chair-to-Bed Transfer Communication

Use clear, sequential cues like “On the count of three, we’re going to stand,” or “Lean forward,” and “Reach toward the bed.”
Emphasize commands like “lift,” “pivot,” and “sit” to synchronize movement

Floor-to-Chair Transfer Errors

Common errors include improper body mechanics, not using enough assistance or equipment when needed, lack of clear communication, and failure to properly support the patient’s weaker side.

Body Mechanics for Lateral Transfers

To minimize strain, avoid forward trunk lean when moving laterally
Consider small incremental steps to allow clinicians to reposition themselves
Minimize lumbar flexion by lifting one leg when moving laterally
Avoid forward trunk leaning when transferring across wide surfaces
Kneel on the bed using the pelvis and lower extremities to stabilize the trunk
Use a series of small steps when transferring across wide surfaces

Hand Positioning for Lateral Transfers

Use a supinated power-grasp
Place hands open and flat on the patient's back or support surfaces to distribute pressure evenly and maintain control
Avoid grabbing to minimize pressure points

Reasons for Needing Three People for a Lateral Transfer

Three people are needed if the patient is heavier, has limited control, or requires strict spinal precautions to maintain alignment

Two-Person Vertical Lift from Wheelchair to Bed

One person is positioned behind the patient, supporting their torso and shoulders, while the other stands in front, supporting the legs or under the knees
The patient should be in a semi-seated position to avoid strain on the back

Cues for Chair-to-Bed Transfers

Use clear and sequential cues, such as "On the count of three, we're going to stand," or "Lean forward," and "Reach toward the bed."
Emphasize commands like "lift," "pivot," and "sit" to synchronize movement

Common Errors in Floor-to-Chair Transfers

Improper body mechanics can lead to strain or injury
Not using enough assistance or equipment when needed
Lack of clear communication
Failure to properly support the patient's weaker side, causing instability

Indications for Using a Hoyer Lift

Patients who are non-weight bearing, completely dependent, or unable to assist in transfers due to severe weakness, decreased mobility, paralysis, or unsteady balance
Also helpful for those with high fall risks or requiring frequent transfers

Special Considerations for a Patient with THA (Total Hip Arthroplasty)

Ensure the affected leg remains in neutral or slightly abducted
Avoid hip flexion beyond 90 degrees
Ensure the sling and leg straps are positioned to prevent rotation

Use of a Hoyer Lift for a Patient Immediately s/p PSF (Posterior Spinal Fusion)

Generally, a Hoyer lift isn't recommended right after PSF due to risk of spinal movement
Use a log roll technique or slippery sheet with assistance to maintain spinal alignment and reduce strain on the spine

What Does "Complete the Transfer" Mean?

“Complete the transfer” refers to ensuring the patient is securely positioned and comfortable at the end of the transfer
This includes removing equipment, adjusting positioning for support, and making sure they have access to necessities like call buttons or blankets

Purpose of a Slippery Sheet

A slippery sheet reduces friction, making lateral transfers easier and less strenuous for both the patient and caregiver

Opting for a Transfer Board over a Slippery Sheet

Use a transfer board if a patient has some upper body strength and control, allowing them to assist with the transfer
This is also useful when bridging a larger gap between surfaces, as transfer boards provide a solid base for the move

Bed to Chair and Chair to Bed Dependent Lift Transfer (Lateral 2 Person Lift)

Patient must be able to weight bear through the lower extremities and have some voluntary muscle tone of one or both legs
Position one clinician behind the patient, preferably the taller and stronger clinician, and another clinician in front of the patient at the feet
When returning to the bed, situate the patient's hips 1/3 down from the head of the bed to minimize repositioning
When returning to the chair, situate the patient's hip as far back in the chair as possible to minimize repositioning

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Description

This quiz covers the essential indications for using a Hoyer lift, especially in patients with varied medical conditions like THA and PSF. Learn the proper techniques and precautions needed for safe patient transfers. Test your understanding of best practices for maintaining patient safety and alignment during lifting.