Question

1.What should the nurse consider in the following situations :

Moving a client up in bed

Respositioning

2. What should the nurse assess in the clinebt proir to transferring the client out if bed.

3. How does the nurse use a transfer belt and transfer board for moving and mobilizing patients?

Answer 1

1.Moving a client up in the bed:

Assess the patient's ability to help with moving

Assemble adequate help to move the patient.
Determine the patient's weight.
Decide on the most effective means of moving the patient.

Ensure that the bed wheels are locked; and start with the bed level

Be sure no catheters or other tubes are attached to the sheets.

Repositioning:

• Patient’s tissue tolerance
• Level of activity and mobility
• General medical condition
• Overall treatment objectives
• Skin condition
• Comfort

2.Always predetermine the number of staff required to safely transfer a patient horizontally.

Explain what will happen and how the patient can help

Assess ABCCS/suction/oxygen/safety.

Ensure tubes and attachments are properly placed prior to the transfer  to prevent accidental removal.

3.Transfer belts are assistive devices which are used by caregivers during transfers of a patient from bed to wheelchair or commode/bath and while walking. A transfer belt used to assist a patient or an elderly person when out for a supervised walk

• Transfer belts should be positioned low on the patient's waist. Pull on the two end pieces to tighten the belt. Remember, that an individual's girth is greater when sitting. It is important that transfer belts are comfortably tight. To remove belt, release clips on the both sides of the buckle.
• There are many different ways to use Transfer Belts to assist an individual to stand or sit. Always transfer to patient's strongest side. Use good body mechanics and a rocking and pulling motion rather than lifting when using a belt. Either the individual, caregiver or both can wear a transfer belt.
• Put the belt around the patient ‘s waist over his clothing with the buckle in front.
• Thread the belt through the teeth of the buckle. Put the belt through the other 2 loops to lock it.
• Be sure the belt is snug with just enough room to get your fingers under it.
• If possible, the patient should be encouraged to push down on the chair or bed, while you lean forward and grasp the belt on both sides. The patient should be held at the waist instead of the arms or shoulders.
• Lift or move the patient with your arm and leg muscles. Do not use your back muscles.
• Do not twist your body when you move or lift the patient .
• When you are done moving or walking with the person, remove the transfer belt.

A transfer board is a piece of equipment that helps you transfer (move) from one surface to another; for example, from bed to chair, or from wheelchair to toilet. The boards come in a variety of shapes, colours and sizes.

1. Sit on the side of the bed. Patient ‘s legs should hang over the edge with feet flat on the floor.

2. The wheelchair should be positioned as close to the bed as possible. It should be placed at an angle to the bed

3. The wheels of the chair should be locked. Both footrests should be moved out of the way. And the armrest nearest to patient should be removed.

4. The nurse should slide one end of the transfer board beneath patient thigh. Point it downward to keep from pinching the skin. Leaning patient ‘s upper body in the opposite direction from the board can make placing the board easier.

5. The other end of the board should be placed flat on the wheelchair seat. The board should point toward the back seat corner farthest from the bed. Also, the front edge of the board should be forward of the wheelchair’s rear wheel.

6. To move across the board, unweight patient body by pushing up with patient’  arms. Next, carefully move patient ‘s body toward the second surface and lower it back onto the board. Repeat, using several short movements instead of one long movement. As patient transfer, lean patient ‘s head and shoulders in the opposite direction of the move. For instance, to move left, lean patient ‘s head and shoulders to the right as patient move patient ‘s buttocks to the left.  

7. Once pat are settled fully on the second surface, the transfer board can be removed.