Transfers

 A transfer is when the therapist moved the client from one place to another. For example, a common transfer is from the bed to a wheelchair, or vise versa. As we have been learning these in class, we have gained knowledge of proper transfers to ensure the clients safety, as well as our own. As I go through some precautions for transfers, I wanted to format it in a way that took us through a whole transfer. What do we need to start with, what do we do during, and what do we do after. 

The first thing to consider before we even try to move the client is whether or not the client will need detailed instructions or extra help. Will they be able to understand your instructions? Talking to the client a little bit and making sure they are on the same page is not only a precaution, but also a great first step. This ensures that you and the client both know what is going to happen, and how it will happen. By spelling out all of the steps, the client can visualize and hear what will happen during the transfer. 

The next thing to consider is if both surfaces are at the right height, and if the breaks are properly stable on the wheel chair. Is the bed low enough to where the client can easily stand without falling? This is not only for there to be a shorter distance form the bed and the wheel chair, but imagine if the bed was too high. If the client tried to step down they would slide off the bed and potentially hurt themselves. Having the bed low enough for them to have their feet on the floor while sitting is very important for safety. Also, if the breaks are not administered on the wheel chair, it could move during the transfer which could also cause a fall. 

Now that we have considered the clients knowledge of what is going on and having the equipment properly situated, we now need to consider the environment. Are there sheets that will be tangled up in the transfer? Does the client have proper footwear? When I shadowed in acute care, we always got the hospital grippy socks before doing transfers. This was to ensure the client would not slip and fall on the slippery floor. Are there are any barriers in the way between the adaptive technology and the bed or wherever the transfer is taking place? Making sure the environment is safe is important for not just the clients safety, but yours too. If they get tangled up in something on the floor and then unexpectedly fall forward, it is you that they are falling on. We need to always be aware of the space. 

Once we are ready, we need to consider our own safety as well. Are we mentally and physically prepared for this transfer? We just made sure the client is ready, but we have to be ready as well. Having a gait belt for extra stability and precaution is important. This allows us to be in control of the whole transfer. The gait belt allowed us to have a nice tight grip on the client. It also allows us as therapists to get our body in proper mechanics, ready to do the transfer. While using a gait belt, we have to make sure it is tight enough that it will not slide up the patient if they fall. Knowing the proper precautions for gait belts insures the clients safety as well as ours. 

Our transfer is complete, and the client is successfully on their bed or wherever we transferred them. We now need to make sure that they will be safe in their new position. We need to make sure they have a large point of contact so that they are stable. We can adjust them to where they are comfortable. If we are transferring a client from their bed to a chair, they should sit comfortably in their chair. We are hurting them further by putting them in a place or position that is uncomfortable to them. Making sure the client is secure, comfortable, and happy should be our final evaluation after the transfer. This is something to consider because we do not want to leave the client in an unsafe situation or position after we are done with the transfer. 

Applying all of these considerations can ensure and safe and successful transfer for both you and your client. The main take aways are to be cautious, take your time, fully explain steps to the client, and be confident! These are all learning curves, but the clients safety is always first. 

Weisser-Pike, O. (2023, May). Lecture 10: Bed Mobility and Transfers. OT 430 Biomechanics, University of Tennessee Health Science Center.