Moving and turning the client in bed

Presented by:
M. Sivanandha Reddy

Definition of
transferring
Transferring refers to moving a
patient from bed to a chair or
to a stretcher, or to a
wheelchair with maximum
comfort and safety for patient
and nurse.

Reasons for
transferring Improvement of the patient’s
condition (from ICU to medicine
unit .
 Worsens of patient’s condition ( to
ICU)
 The need for surgery or X ray
 Transfers at the patient’s request
 For any other diagnostic tests.

Reasons formoving
Change position
Repositioning the client
Client’s slid down in bed
from fowler’s position
Changing the bed linen

Methods of transferring
By wheel chair
By stretcher
By a movable bed

Assess:
 The client’s physical abilities
 Ability to understand instructions
 Degree of comfort ordiscomfort when
moving
 Client’s weight
 Presence of orthostatic hypotension
 Yourown strength and ability to move
the client

 If indicated, use pain relief
modalities ormedication prior to
moving the client
 Prepare supportive equipment
(pillows)
 Obtain required assistance
 Explain the procedure to the client
and listen to any suggestions the
client

 Wash hands
 Raise the height of the bed to bring
the client close to yourcenterof
gravity
 Lockthe wheels on the bed and raise
the rail on the side of the bed
opposite you to ensure client safety
 Face in the direction of the
movement to prevent spinal twisting

Transferring the patient
frombed to wheel chair:
1.Review the medical record and nursing
plan of care forconditions that may
influence the
patient’s ability to move orto be positioned
2.Performhand hygiene and put on PPE, as
indicated. Identify the patient. Explain
the procedure to the patient
3.Provide privacy
4.Raise the head of the bed to a sitting

5.Make sure the bed brakes are locked. Put
the chairnext to the bed. If available, lock
the brakes of the chair. If the chairdoes not
have brakes, brace the chairagainst a secure
object
6.Lowerthe side rail, if necessary, and stand
nearthe patient’s hips. Stand with yourlegs
shoulderwidth apart with one foot nearthe
head of the bed, slightly in front of the other
foot
7.Assist the patient to sit up on the side of
Transferring the patient from
bed to wheel chair:

8.Wrap the gait belt around the patient’s
waist, based on assessed need and facility
policy
9.Stand facing the patient. Spread yourfeet
about shoulderwidth apart and flex your
hips and knees
10.Askthe patient to slide his orherbuttocks
to the edge of the bed until the feet touch
the floor.
11.Position yourself as close as possible to the
patient, with yourfoot positioned on the out
Transferring the patient from
bed to wheel chair:

12.Using the gait belt, assist the patient to
stand
Rockbackand forth while counting to three.
On the count of three, use yourlegs (not
yourback) to help raise the patient to a
standing position . If indicated, brace your
front knee against the
patient’s weakextremity as he orshe stands
13.Pivot on yourbackfoot and assist the
patient to turn until the patient feels the

14.Askthe patient to use an armto steady him-
orherself on the armof the chairwhile slowly
lowering to a sitting position . Continue to
brace the patient’s knees with yourknees and
hold the gait belt. Flex yourhips and knees
when helping the patient sit in the chair.
15.Assess the patient’s alignment in the chair.
Remove gait belt , if desired. Depending on
patient comfort, it could be left in place to
use when returning to bed. Coverwith a
blanket, if needed.

Transferring the patient from bed to stretcher
and from the stretcher to the bed is done to
patients who cant help themselves and need
help.
The selection of transfer technique is
individualized.
The following methods can be used.
1.Draw sheet method
2.Patient is lifted by three persons
3.Mechanical devices like hydro ureter lift

Moving and turning the client in bed

Lowerthe head of the bed until it is
flat.
Raise the bed so that it is slightly
higherthan the surface of the
stretcher.
Ensure that the wheels on the bed are
locked.
Pull the draw sheet out from both
sides of the bed.

Fournurses orhelpers are
required.
One stands at the opposite side of
the bed. Remaining three stands
across the stretcherone
supporting the head and
shoulders, second one supporting
the hips and thighs and the third

1.Grasp the draw sheet tightly
2.Co-ordinate lifting by counting the
numbers of 1, 2, 3 and receive the
patient in stretcher by pulling the draw
sheet and the patient towards the
stretcher, quickly and gently.
3.The sheet can be removed by turning
the patient from side to side.

Three persons lifting the patient
1.Three people, all standing on the same
side of the patient, slip their hands, palms
facing up, beneath the patient.
2.First person holds the head and shoulder,
second person holds the trunk upto thigh
and the third person holds the legs.
3.Cradle the patients in the arms so that
the patients weight rests against the
nurses chests and the patient faces
nurses.

Three persons lifting the patient
4.Care must be taken so that the patient
will not be dropped down suddenly.
5.The nurses should bend over and
release the weight of the patient
gradually and until it rests gently upon
the bed or stretcher.

Moving the client up in bed
1.Review the medical record and nursing plan
of care for conditions that may influence the
patient’s ability to move or to be positioned.
2.Assess for tubes, IV lines, incisions, or
equipment that may alter the positioning
procedure. Identify any movement
limitations.
3.Consult patient handling algorithm for
moving the patient.

5.Perform hand hygiene and put on PPE
6.Identify the patient. Explain the procedure
to
the Patient
7.Close curtains around bed and close the
door
to the room, if possible
8.Adjust the head of the bed to a flat position
9.Remove all pillows from under the patient.
Leave one at then head of the bed, leaning

9.Position at least one nurse on either side of
the bed, and lower both side rails
10.Ask the patient (if able) to bend his or her
legs and put his or her feet flat on the bed to
assist with the movement.
11.One nurse should be positioned on each
side of the bed
12.Grasp the friction-reducing sheet securely,
close to the patient’s body

13.Flex your knees and hips. Tighten your
abdominal and gluteal muscles and keep
your back straight
14.On the count of three, move the patient up
in bed
15.Assist the patient to a comfortable position
and readjust the pillows and supports, as
needed. Return bed surface to normal setting

Moving and turning the client in bed

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