Safe Patient Transfers

Caring for homebound patients presents unique challenges, one of which is the safe transfer of patients from one place to another. Whether you are a caregiver, a family member, or a healthcare professional, understanding the best ways and tools to safely move patients is essential.

If you work with homebound patients, you know how challenging it can be to move them from one place to another. Whether it's understanding how to transfer patients from bed to wheelchair, from the wheelchair to the car, or from the car to the doctor's office, transferring patients safely requires skill, patience, and the right patient transfer device.

That’s why we’ve put together this helpful guide to moving and transferring homebound patients safely and with confidence.

Patient transfer: why it matters

As a home caregiver, you have a duty to ensure that your patients are comfortable, secure, and free from harm during any movement or transfer.

Besides basic mobility, there are good reasons to transfer patients, such as:

• To reduce the risk of injury to yourself and your patient
• To improve your patient's mobility and independence
• To enhance your patient's quality of life and dignity

Ensuring a safe patient transfer is critical because incorrectly moving someone with mobility issues can result in serious consequences for the patient including:

• Causing pain, discomfort, or distress to your patient
• Damaging your patient's skin, muscles, bones, or joints
• Increasing your patient's risk of falls, fractures, or infections
• Compromising your patient's safety and privacy
• Straining your back, neck, shoulders, or arms
• Leading to legal liability or professional negligence

Therefore, it is essential that you learn how to transfer patients safely and follow the best practices and guidelines for each situation.

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Types of Patient Transfers

There are different types of patient transfers depending on the level of assistance needed, and the destination of the transfer. For example, a bed transfer technique may differ from transferring a patient from a stretcher to bed. It also can vary depending on the equipment available. Some of the most common types of patient transfers are:

Stand pivot transfer: This is when you help your patient stand up from one surface (such as a bed or a chair) and pivot them to another surface (such as a wheelchair or a toilet). This type of transfer requires that your patient has some strength and balance in their legs and arms.

Slide board transfer: This is when you use a rigid board (such as a wooden or plastic board) to slide your patient from one surface to another (such as from a wheelchair to a car seat). This type of transfer requires that your patient has some upper body strength and can lift their hips slightly.

Here’s how to use a slide board to transfer a wheel-bound patient to a car:

 

Mechanical lift transfer: This is when you use a mechanical device (such as a hoist or a sling) to lift your patient from one surface to another (such as from a bed to a bathtub). This type of transfer requires that your patient has little or no mobility and needs full assistance.

Gait belt transfer: This is when you use a belt (such as a canvas or leather belt) to support your patient's waist while they walk or move from one place to another (such as from the bedroom to the living room). This type of transfer requires that your patient can bear some weight on their legs and can cooperate with your instructions.

Here’s a guide to performing functional transfers:

Tools and Equipment for Patient Transfers

There are different tools and equipment available to help you make the process easier, depending on what the different types of patient transfer are. These patient transfer devices are designed to make it safer, and more comfortable for both you and your patient. Some of the most useful tools and equipment for patient transfers are:

Transfer boards: These are rigid boards that can help you slide your patient from one surface to another without lifting them. They come in different shapes, sizes, and materials, such as wood, plastic, or metal. They usually have handles or cutouts for gripping and may have a smooth or textured surface for friction.

Transfer discs: These are circular platforms that can help you pivot your patient from one surface to another without moving their feet. They have a swivel mechanism that allows them to rotate 360 degrees. They usually have non-slip surfaces and may have handles for stability.

Transfer belts: These are belts that can help you support your patient's waist while they stand, walk, or move. They are usually made of canvas or leather and have buckles or Velcro closures. They may have handles or loops for gripping and may have padding for comfort.

Transfer slings: These are fabric devices that can help you lift your patient from one surface to another using a mechanical lift. They wrap around your patient's body and have straps or hooks that attach to the lift. They come in different sizes, shapes, and materials, such as nylon, polyester, or mesh. They may have head support, leg support, or openings for toileting.

Transfer sheets: These are sheets that can help you slide your patient from one surface to another without lifting them. They are usually made of cotton or polyester and have handles or loops for gripping. They may have low-friction coatings or glide mechanisms for easier movement.

Transfer poles: These are vertical poles that can help your patient stand up or sit down from a surface. They are usually made of metal or wood and have a base that secures to the floor or ceiling. They may have handles, bars, or straps for gripping and may have height adjustments for different users.

Best Practices and Tips for Patient Transfers

To ensure that you transfer your patient safely and effectively, you should follow some best practices and tips, such as:

• Assess your patient's condition and needs before each transfer. Consider their level of mobility, strength, balance, cognition, pain, and cooperation. Also, check their medical history, medications, and any special precautions or contraindications.
• Plan your transfer ahead of time. Choose the most appropriate type of transfer, the best destination, and the right tools and equipment. Also, prepare the environment by clearing any obstacles, locking any wheels, adjusting any heights, and securing any cords or tubes.
• Communicate with your patient throughout the transfer. Explain what you are going to do, how you are going to do it, and why you are doing it. Ask for their consent, feedback, and preferences. Give clear and simple instructions and cues. Encourage and praise their efforts.
• Use proper body mechanics and ergonomics during the transfer. Keep your back straight, your knees bent, and your feet apart. Align your center of gravity with your patient's center of gravity. Lift with your legs, not your back. Avoid twisting, reaching, or jerking movements. Use smooth and coordinated motions.
• Seek help if needed. Do not attempt to transfer your patient alone if they are too heavy, too unstable, or too uncooperative. Ask for another caregiver's assistance or use a mechanical lift if necessary. Do not risk injuring yourself or your patient by trying to do more than you can handle.

Safe patient transfers are of paramount importance when caring for homebound individuals. By understanding the significance of safe transfers, mastering essential techniques, and utilizing the right tools and equipment, you can ensure the well-being and comfort of your patients, whether you are a caregiver, a family member, or a healthcare professional.

FAQs

Q: How often should I transfer my patient?
The frequency of patient transfers depends on several factors, such as their medical condition, their comfort level, their skin integrity, and their activity level. Generally speaking, you should transfer your patient at least every two hours to prevent pressure ulcers, muscle stiffness, blood clots, and other complications.

Q: How can I prevent falls during patient transfers?
To prevent falls during patient transfers, you should follow these steps:

1. Assess your patient's risk of falling before each transfer. Use a standardized tool such as the Morse Fall Scale or the Hendrich II Fall Risk Model to evaluate their fall risk factors.

2. Implement fall prevention strategies based on your assessment. For example, use a gait belt or a transfer disc if your patient has poor balance; use a slide board or a transfer sheet if your patient has limited mobility; use a mechanical lift or a transfer sling if your patient has no mobility.

3. Monitor your patient closely during the transfer. Watch for any signs of dizziness, weakness, confusion, or fatigue. Stop the transfer immediately if you notice any problems or concerns.

Q: How can I protect my patient's skin during patient transfers?
To protect your patient's skin during patient transfers, you should follow these steps:

1. Inspect your patient's skin before and after each transfer. Look for any redness, swelling, blisters, bruises, or wounds that may indicate skin damage or infection.

2. Use appropriate tools and equipment that minimize friction and shear forces on your patient's skin. For example, use a low-friction transfer sheet instead of a regular sheet; use a padded transfer sling instead of a bare sling; use a smooth transfer board instead of a rough board.

3. Apply moisturizers and barrier creams to your patient's skin as needed. This can help prevent dryness and irritation that may lead to skin breakdown.

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