Unit 2
 Manual patient handling: moving a pt by hand or bodily force, including pushing,
pulling, carrying, holding etc
 Types of transfers:
 Standing transfer: Pt stands during transfer with help of 1 or 2 assistants
 Sitting transfer: Pt sits throughout transfer ex. With sliding board
 Sliding board: a plastic or wooden board, about 2 feet long with slippery surface, used for
sitting, lateral transfer
 Mechanical lift: manually operated lift used for sitting, vertical movements
 Which transfer to use? Nurse or physical therapist determines; depends on:
 Pt’s physical condition:
 Paralysis: inability to move 1 or more extremity; ex. Paraplegia, hemiplegia
 Paresis: weakness of 1 or more extremity
 Amputation: absence of an extremity
 Recent hip surgery etc
 Pt’s strength, endurance, balance:
 Respiratory disease
 Cardiac disease
 Neurological diseases ex. Multiple sclerosis, CVA, Parkinson's
 Ability to bear weight = stand on own feet
 Non weight-bearing: no weight allowed on that leg or both legs
 Partial weight-bearing: some weight allowed on that leg or both legs
 Full weight-bearing: full weight allowed
 Has to have at least partial weight-bearing on 1 leg for standing transfer!
 Pt’s mental condition: can pt understand and follow instructions?
 Pt’s size: height and weight
 Pt’s ability to assist
 Pt’s ability to bear weight
 Pt’s upper-extremity strength
 Pt’s ability to cooperate/follow directions
 Pt’s size: if pt is larger than you, you definitely will need
help, if pt smaller, depends on situation
 Special circumstances: wounds, surgical sites, IVs, tubes,
contractures; transfer must never pull or displace a tube
during transfer!!
 Physician or therapy orders, ex. Hip surgery, partial- or non-
weight bearing etc
See Figure 16.3 p. 270
 Read and know them, especially
 Never allow pt to place their hands on your body during transfers
 Never transfer pt by placing your hands under pt’s arms or shoulders
 Always lock all wheels
 Pt needs shoes or non-skid socks
 Brace the knee of the weak or paralyzed leg with your knee or leg
 Support weak or paralyzed arm, no dangling or pulling
 WC: always position large part of small front caster facing forward and lock breaks = more
stable
 All the others on that page…
 Assistive device, 1.5-2inches wide, 54-60inches long, for transfer and ambulation
 Transfer belt: when used to help transfer pt
 Gait belt: when used to help ambulate pt
 Avoids grasping pt under arms or around rib cage
 NOT used to “lift” pt, if pt unable to bear weight – sitting transfer!
 Contraindications:
 Injuries along abdomen, back, ribs including surgery
 Abdominal pacemaker, Advanced heart or lung disease, Abdominal aneurysms
 Pregnancy, Colostomy, Gastrostomy or feeding tube
 Always,
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applied OVER pt clothing or gown, never directly on skin, use towel if necessary
Applied at waist level, no twists in it
Buckled in front
Needs to be snug but not too tight: able to fit 3 fingers from each hand under it
Procedure 18 p. 271!!
 Pt must have good upper body strength, sitting balance, be able to lift buttocks off bed
 Used for paraplegia or weakness in both legs = sitting transfer
 Use transfer belt
 Arms from chair must be removable
Procedure 21 p. 276
 Frightening for pt, ensure it’s safe
 Procedures 25, 26 for unconscious/ semiconscious pt
Procedure 25 and 26 p. 280-282
 Sitting transfer for heavy pt, pt unable to assist
 Best used with 2 or more CNAs
Procedure 27 p. 283-284
(video)
 Assisting pt onto and off the toilet
Procedure 28 p. 285-286
Step
 Skill # 4!!
 Procedure
18+19 p.
271-274
P/F
1
2
Performs beginning standards
Explains procedure to resident before care
3
4
Provides privacy
Positions wheelchair beside bed, folds up/removes foot rests, locks wheels
5
Positions bed at an appropriate height, locks wheels
6
Assists resident safely to sitting position with feet flat on floor, puts on shoes or non-skid socks
7
Gives resident time to adjust to position change, asks if ok
8
Applies transfer belt correctly and securely over clothing at waste
9
Provides instructions to enable resident to assist in transfer including prearranged signal and to use
hands to push off from mattress if able
Stands facing resident, positioning self to ensure safety for self and resident during transfer
10
11
On signal, gradually assists resident to stand by using transfer belt on both sides with upward grasp
maintaining stability of resident’s legs
12
Transfers resident as a pivot to stand before wheelchair with back of resident’s legs against wheelchair
13
Lowers resident slowly into wheelchair
14
Positions resident with hips touching back of wheelchair
15
16
17
18
19
Removes transfer belt correctly
Positions feet on footrests
Puts call bell within reach
Washes hands
End procedures
Procedure 20 p. 274-275
 Difference to one person assist:
 1 assistant on each side of pt, facing pt
 Each assistant grabs transfer belt at front and back with underhand grasps
 Assistant closest to chair pivots around smoothly, stands with outside leg further back
 Assistant closest to bed uses inside knee to brace pt’s weaker leg
 Everyone moves together on 3…
Procedure 22 p. 277-278 : assist of 1
 Place chair so pt moves towards his strongest side
Procedure 23 p. 278-279 : assist of 2
Procedure 24 p. 279 : Independent transfer = standby assist
Homework (besides practice)
Textbook: read Unit 16
Workbook: read p.100 unit summary, Nursing assistant alert, complete “Corrections” and
True/False questions, Look at “Identification” to find things wrong in pictures