Tidewater Community College PTH 105 Transfers Fall 2024 PDF

TIDEWATER COMMUNITY COLLEGE PTA PROGRAM VA BEACH CAMPUS PTH 105 -- [Unit 5 Lab] - [HO \#3] - [Transfers Fall 2024] (Reference: Fairchild Ch 8) **Learner Objectives**: B2. Describe the levels of assistance required in performing transfers. B3. Discuss the safety issues involved in patient trans...

TIDEWATER COMMUNITY COLLEGE PTA PROGRAM VA BEACH CAMPUS PTH 105 -- [Unit 5 Lab] - [HO \#3] - [Transfers Fall 2024] (Reference: Fairchild Ch 8) **Learner Objectives**: B2. Describe the levels of assistance required in performing transfers. B3. Discuss the safety issues involved in patient transfers, including: e. B4. Describe and demonstrate the following transfer techniques, including patient and/or caregiver instruction for: a. b. c. d. e. [Transfer] -- moving a patient from one surface to another [Bed Mobility] -- moving a patient from one position to another in bed (Book combines bed mobility and transfers under one common definition, we will not -- they are 2 different entities. Bed mobility is covered in Unit 6) **[General principles when transferring a patient]**: 1\. Surfaces MUST be secured. Lock wheels on WC, plinth, bed, stretcher, etc. 2\. Surfaces should be at same height or as level as possible. 3\. Positioning of surfaces is critical. Surfaces should be positioned as close as possible to each other to eliminate \"holes\" where patient may fall. Angle between W/C and bed should be **[parallel]** or 45-60°. 4\. To decrease workload, move patient as close to edge of surface as possible prior to assisting patient to stand; 'rock' patient to overcome inertia. Do not 'rock' THA patients. 5\. Move extraneous equipment out of the way prior to transfer (ex: leg rests, bed rails, arm rests, IV poles). 6\. Be careful with hand placements. Avoid holding onto joints or fragile areas. 7\. Support/protect patient\'s extremities. 8\. Tell patient what you plan to do, what is expected of him/her and anything they should not do (ex. Do not grab around my neck) 904241008. Always wear shoes with rubber soles. Patients should wear rubber-soled shoes. 10. Use good body mechanics. Get help if you need it. 11. Transfer to patient's strong side if possible (during early rehab, eventually need to transfer to both sides) 12. Do not pivot an orthopedic (TKA, THA, ACL, fx) patient on their injured limb. You must place involved leg forward during sit ↔ stand to minimize WB 13. Neurologic dx (CVA, MS, CP) -- encourage FWB so keep both LEs bent equally during sit ↔ stand 14. Know precautions/limitations. (table 83, p. 173 -- THA, LBP, SCI, burns, hemiplegia) - - - - - - - - - - **Weight Bearing Status** -- for transfers and gait training (O'Sullivan: p. 464) ================================================================================= 1\. NWB = non-weight bearing; foot/toes make no contact with floor 2\. Toe-touch WB (TTWB) or touch down WB (TDWB) = patient may rest toes on floor for balance. Instruction: "toes only for balance". 3\. PWB = partial weight bearing; expressed as a percentage of body weight; usually 20-50% of body weight 4\. WBAT = weight bearing as tolerated; WB without pain; pt able to progress to FWB when ready 5\. FWB = full weight bearing (no restrictions) **[Levels of Assistance]:** (Fairchild: Table 8-1; p. 170) 1. *Independent (I)* = patient needs no assistance or supervision. 2. *Modified Independent* (*mod (I)*) = patient performs task (I) but requires an assistive device such as an AFO or a cane. 3. *Supervision (S) or Stand-by Assist (SBA)* = patient requires no hands-on assistance but needs close guarding for safety; may requires verbal or tactile cues (vc or tc) 4\. *Contact Guard (CG/CGA)* = hands are physically on patient to guard and/or guide him/her. 5\. *Minimal* (*Min (A))* = patient performs \> 75% of work. 6\. *Moderate* (*Mod (A))* = patient performs 50% -74% of work. 7. *Maximum* (*Max (A))* =patient performs 25% - 49% of work. 8. [**Equipment used during transfers**:] 1. 2. 3. 4. 5. 6. 7. **[Types of Patient Transfers]:** 1. 2. 3. 4. 5. 6. a. b. c. d. e. f. **Patient Transfers** --------------------- 904245008. **[Stand-Step (if NWB, TDWB, WBAT, FWB) Transfer]** - - - [Positioning of patient]: - - - - - - - - [To Transfer Patient (minimum assist):] - - - **2. [Sliding Board Transfer]** This type of transfer is used with patients who are unable to WB on LEs (SCI, 904244128. Depress shoulder girdle 1. 3. **[Floor to Chair] (independent or with assistance of family) -** get strong side next to a stable surface and pull up into half kneeling. Might need to roll or crawl to stuffed couch/chair or coffee table 4. **[Car Transfer]** - this is just a stand-step, stand-pivot, sit-pivot or sliding board transfer. Be sure the patient does not pull on the movable car door. **[How to determine type of transfer]**: - - - - - - - - **[Patient Lifts (2 or 3 person lift)]:** **A. [2 Person Recumbent Lift without drawsheet] (moving pt in bed/moving bed-to-bed)** 904240288. **B. [2 Person Recumbent Lift with drawsheet] (moving pt in bed/moving bed-to-bed)** 904241888. C. **[3 Person Recumbent Lift] -- (pt rolled to side and lifted up and out of bed)** 1. 2. 3. 4. **D. [2 Person Seated Lift] -- (chair-to-chair / chair-to-bed)** 904241889. **E. [2 Person Seated Lift] -- (floor-to-bed/chair)** **F. [Hoyer Lift]** - Type of equipment that may be needed to transfer/lift a patient who is too heavy for available personnel to handle. Equipped with a hydraulic lift that supports patient in sitting position in a sling and moves patient from one surface to another. This lift may be electric or operated manually be lever or foot pedal. [Sample Transfers "S and O"]: Updated 8/14/22 -- Dr. B Sample 1: 8/14/22 S: Patient is eager to go home but is a bit nervous about getting up his three front steps. States he will be going home with his wife and will need to walk from his living room to the bathroom. Melanie Basinger, PT, DPT, MS Sample 2: 8/14/22 S: Patient reports weakness in (L) side. She has difficulty going up and down stairs, standing, and walking.