L5 Patient Transfer PDF

Chapter 8 Patient Transfer  Exam 1 18-20 16-18 14-16 12-14 10-12  Objectives  Demonstrate the practice of good body mechanics when lifting and moving heavy objects.  List two steps to be taken to ensure the accuracy of patient identification.  Demon...

Chapter 8 Patient Transfer  Exam 1 18-20 16-18 14-16 12-14 10-12  Objectives  Demonstrate the practice of good body mechanics when lifting and moving heavy objects.  List two steps to be taken to ensure the accuracy of patient identification.  Demonstrate safe techniques for moving and transferring patients, using the principles of good body mechanics.  Safely assist a patient into and out of a wheelchair.  Use a gait belt to assist a weak patient to stand and walk.  List precautions for moving and positioning patients following a surgical hip replacement.  Perform a two-person transfer of a patient from bed to stretcher and stretcher to bed.  Demonstrate the use of draw sheets, a slider board, and a sliding mat to facilitate stretcher transfers.  Key Terms  Draw sheet  Gait belt  Gurney  Orthostatic hypotension  Sedation  Slider board  Sliding mat  Stretcher  Body Mechanics (1 of 2)  The principles of proper body alignment, movement, and balance Body Mechanics (2 of 2)  Rules of Body Mechanics  Provide a broad base of support.  Work at a comfortable height.  When lifting, bend your knees and keep your back straight.  Keep your load well-balanced and close to your body.  Roll or push a heavy object. Avoid pulling or lifting.  Patient-Transfer Considerations  Moving patients from one place to another in a hospital requires wheeled transport. Only method to ensure patient safety  Wheelchairs are used for those who can sit upright  Stretchers used for those too weak to sit  Small children may be transported in cribs.  Infants may be transported in incubators.  Preparation for Transfer  Check with the nursing service.  Check patient identification.  Plan what you are going to do and prepare your work area.  Obtain equipment and check it for safety and function.  Enlist the patient’s help and cooperation. Communicate with the patient what you are doing.  Obtain additional help when necessary. Communicate the role of assistants in the transfer plan.  Bed-to-Wheelchair Transfers (1 of 6) 1. Lower the bed to wheelchair level, and elevate the head of the bed. 2. Position the wheelchair parallel to the bed with wheels locked and footrests out of the way. 3. With the patient in the supine position, place one arm under the patient’s shoulders and one under the knees, and in a single, smooth motion, raise and turn the patient to a sitting position with his or her feet dangling over the side. 4. At this point, competent patients can stand and move to the wheelchair with little assistance, although a steadying hand at the patient’s elbow is a good practice. Bed-to-Wheelchair Transfers (2 of 6) Bed-to-Wheelchair Transfers (3 of 6)  Bed-to-Wheelchair Transfers (4 of 6)  A gait belt, or transfer belt, which provides a secure hold, should be used with weak, unsteady patients. Grasp the gait belt or reach around the patient and place your hands firmly over the scapulae; the patient’s hands may rest on your shoulders. On your signal, lift upward to help the patient stand. Use a broad base of support and keep your back straight. Now instruct and assist the patient to pivot a quarter turn so that the edge of the wheelchair is touching the back of the patient’s knees; then ease the patient into a sitting position in the chair. Position the footrests and leg rests, and cover the patient’s lap and legs with a sheet or bath blanket to provide warmth and comfort and to protect the patient’s modesty. Bed-to-Wheelchair Transfers (5 of 6)  Bed-to-Wheelchair Transfers (6 of 6)  Falls most commonly occur when the patient sits in a wheelchair. May miss the edge of the seat or tip the chair by sitting too near the edge  To avoid such an accident, be sure to lock the wheels of the chair and assist the patient until seated securely. Wheelchair-to-X-Ray Table Transfers (1 of 2)  Place the wheelchair parallel to the table, lock the brakes, and move the footrests out of the way.  Adjustable-height table—lower to chair height Help the patient to stand and pivot with the patient’s back to the table. Then ease the patient into a sitting position on the edge of the table.  Stationary table—place step stool with a tall handle nearby Have the patient place one hand on the stool handle, put the other arm on your shoulder, and step up onto the stool, pivoting with the back to the table. Now ease the patient to a sitting position. Wheelchair-to-X-Ray Table Transfers (2 of 2)  After the patient is seated on the table, raise the table if its height is adjustable.  Place one arm around the patient’s shoulders and one under the knees. With a single, smooth motion, place the patient’s legs on the table while lowering the head and shoulders into the supine position. Patients with back pain may want to lie on one side before moving into the supine position. Special Considerations for Wheelchair Transfers  Stroke victims  Fractures of the lower extremity  Joint replacement  Spinal trauma or surgery  Patients who cannot stand safely Require a hydraulic lift for transfers Do not use until proper instruction and training are obtained.  3-Hydraulic lift techniques For patients who are too heavy to lift manually  Two Persons Lift For patient cannot bear weight on their lower extremities. Two person transfer  Precautions for Patients with Hip Replacements Surgery via the Anterior Approach Surgery via the Posterior Approach May sit upright Must not flex hip beyond 90 degrees Weight bearing is usually tolerated Weight bearing is usually tolerated (check chart) (check chart) Avoid abduction Abduction is permitted Avoid adduction Avoid adduction Avoid internal or external rotation Avoid internal rotation Avoid hyperextension  Stretcher Transfers  Three methods: Draw sheet Slider board Sliding mat  Sheet Transfer  Roll the top portion of the folded sheet so it is close to the patient’s back  Roll the patient over the roll and facing the opposite direction  Unroll the sheet. It is now ready to use to lift or slide a patient.  Lateral Transfer Sliding Board  Roll the patient away from the direction of the move to place the sliding board partly under the patient.  Create a bridge between the table and the gurney.  Roll the patient back onto the board, and slide the patient across the board.  Remove the board by slightly rolling the patient off it. https://www.youtube.com/watch?v=ja z80bqc150  Safety Side Rails  Required to be in up and locked position: For patients who are impaired or unconscious During transport When patients are left unattended on a stretcher