TRANSFERRING A PATIENT FROM A BED TO A CHAIR WITH THE ASSISTANCE OF ANOTHER NURSE 1.

Review the medical record and nursing plan of care for conditions that may influence the patients ability to move or to be positioned. Assess for tubes, intravenous lines, incisions or equipment that may alter the positioning procedure. Identify any movement limitations. 2. Identify the patient. Explain the procedure to the patient. 3. Perform hand hygiene and put on gloves, if necessary. 4. If needed, move the equipment to make room for the chair. Close the door or draw the curtains. 5. Make sure the bed brakes are locked. Adjust the height of the bed to comfortable working height or at the level of the armrest (if one is present) on the chair. 6. Move the patient to the near side of the bed while patient crosses his arms on his chest if possible. Position the chair next to the bed near the upper end with the back of the chair parallel to the head of the bed. If possible, remove the armrest closest to the bed. Lock the chair wheels, if available. Use a chair transfer board if appropriate. 7. Prepare to lift the patient from the bed to the chair. Have the lead nurse stand behind the chair and slip his or her arms under the patients axillae and grasp the patients wrist securely. The second nurse faces the wheelchair and supports the patients knees by placing his or her arms under the patients knees. 8. On a predetermined signal, flex hips and knees, keeping backs straight and simultaneously lifting the patient and gently lowering patient into the chair. If necessary, use a chair transfer board. 9. Adjust the patients position using pillows if necessary. Check his alignment in the chair. Cover the patient with a blanket if necessary. Place the call bell within reach. 10. Perform hand hygiene. Document the activity, transfer, and observations, the patients tolerance, and the length of time in the chair.

TRANSFERRING A PATIENT USING A HYDRAULIC LIFT 1. Review the medical record and nursing plan of care for conditions that may influence the patients ability to move or to be positioned. Assess for tubes, intravenous lines, incisions or equipment that may alter the positioning procedure. Identify any movement limitations. Identify the patient. Explain the procedure to the patient. Perform hand hygiene and put on gloves, if necessary. If needed, move the equipment to make room for the chair. Close the door or draw the curtains. Bring the chair to the side of the bed. Lock the wheels, if present. Adjust the bed to a comfortable working height. Lock the bed brakes. Place the sling evenly under the patient. Roll the patient to one side and place half of the sling with the sheet or pad on it under the patient from shoulders to midthigh. Roll the patient to the other side and pull the sling under the patient. Roll the base of the lift under the side of the bed nearest to the chair. Center the frame over the patient. Lock the wheels of the lift. Using the base-adjustment lever, widen the stance of the base.

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10. Lower the arms close enough to attach the sling on the frame. 11. Place the strap or chain hooks through the holes of the sling. Short straps attach behind the patients back and long straps at the other end. Check the patient to make sure the hooks are not pressing into the skin. Some lifts have straps on the sling that attach to hooks on the frame. Check the manufacturers instructions for the specifics for each particular lift. 12. Check all equipment, lines, and drains attached to the patient so that they are not interfering with the device. Instruct the patient to fold his or her arms across the chest. 13. With a person standing on each side of the lift, tell the patient that he or she will be lifted from the bed. Support injured limbs as necessary. Engage the pump to raise the patient about 6 inches above the bed. 14. Unlock the wheels of the lift. Carefully wheel the patient straight back and away from the bed. Support the patients limb as needed. 15. Position the patient over the chair with the base of the lift straddling the chair. Lock the wheels of the lift. 16. Gently, lower the patient to the chair until the hooks or straps are slightly loosened from the sling or frame. Guide the patient into the chair with your hands as the sling lowers. 17. Disconnect the hooks or strap from the frame. Keep the sling in place under the patient. 18. Adjust the patients position using pillows if necessary. Check his alignment in the chair. Cover the patient with a blanket if necessary. Place the call bell within reach. When time for the patient to return to bed, reattach the hooks or straps and reverse the steps. 19. Perform hand hygiene. Document the activity, transfer, and observations, the patients tolerance, and the length of time in the chair.