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Unit 16

Unit 16. The Patient’s Mobility: Transfer Skills. Let’s get Moving!. Introduction. As a nursing assistant, you will work with many patients who have impaired mobility. In the last unit, you learned how to move and position patients in bed.

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Unit 16

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  1. Unit 16 The Patient’s Mobility: Transfer Skills

  2. Let’s get Moving!

  3. Introduction • As a nursing assistant, you will work with many patients who have impaired mobility. • In the last unit, you learned how to move and position patients in bed. • In this unit, you will learn how to transfer patients.

  4. Nursing Assistant Safety • Patient lifts and transfers are listed as tasks with the highest risk of injury because: • Workers end up in awkward positions and confined spaces • Workers are bending or reaching while the back is flexed

  5. Nursing Assistant Safety • Factors that further increase the risk of injury are: • Patient weight • Transfer distance • Confined workspace • Lateral patient transfers • Unpredictable patient behavior • Stooping, bending, and reaching

  6. Nursing Assistant Safety • Although the nurse or therapist selects the method of transfer • You will need to determine if you will need another person or piece of equipment to assist you

  7. Nursing Assistant Safety • Key elements for you to consider are: • Patient’s ability to assist with the procedure • Patient’s ability to bear weight • Patient’s upper extremity strength • If a sliding board or certain other transfers are used

  8. Nursing Assistant Safety • Key elements for you to consider are: • Patient’s ability to cooperate and follow directions • Patient’s size (height and weight) compared with your size

  9. Nursing Assistant Safety • Key elements for you to consider are: • If the patient is larger than you are • You may need help from another assistant or a mechanical device • If the patient is smaller than you are, is dependent, or cannot cooperate • You may also need help

  10. Nursing Assistant Safety • Key elements for you to consider are: • Wounds • Surgical sites • Catheters, IVs, tubes, contractures, etc. that restrict or interfere with mobility • Always get help if there is danger of removing a tube during transfer

  11. Nursing Assistant Safety • Key elements for you to consider are: • Special physician orders or therapy recommendations for transfers and positioning • Such as you would see in a patient who has had hip surgery

  12. Nursing Assistant Safety • Some facilities have implemented “no lift” policies • “No manual lifting” should be done

  13. Need a Lift?

  14. Nursing Assistant Safety • Facilities with “no lift” or “zero lift” policies • Usually depend on mechanical aids to reduce friction when moving a patient

  15. Nursing Assistant Safety • Some use a combination of mechanical, electrical, and ceiling-mounted lifts for moving patients vertically • Many facilities require the use of gait belts

  16. Types of Transfers • Basic types of transfers are: • Standing transfer • Sitting transfer • Lateral transfer • Vertical transfer • Done with a mechanical lift

  17. Transfers • A transfer belt • Webbed belt 1½ to 2 inches wide and about 54 to 60 inches long • Assistive and safety device used to transfer or ambulate patients

  18. Transfers • During transfer and when wheelchair is parked • Always position small front wheels facing forward and lock brakes • Refer to Figure 16-2 Brake

  19. Transfers • A sliding board is a plastic or wooden board that is about two feet long with a slippery surface

  20. Stretcher Transfers • To move a patient from his or her room to another room for surgery, treatment, or diagnostic testing • Procedure may be very frightening to the patient • Assure patient that procedure is safe

  21. Moving the Patient with a Mechanical Lift • For moving heavy patients who have little or no ability to assist • Safer for both the patient and nursing assistant

  22. Moving the Patient with a Mechanical Lift • Moves patient from one surface to another by means of a vertical transfer • Many types of mechanical lifts are used

  23. Toilet Transfers • Bladder is emptied much more efficiently if a patient can use a toilet or commode rather than a urinal or bedpan • To use the toilet • Patient must possess transfer skills

  24. Tub Transfers • In the institutional setting • A shower with chair or a tub with hydraulic lift is available • If the patient is at home • A tub chair, a rail on the wall beside the tub, and slip-proof mats in the tub are needed for safety

  25. Car Transfers • You may need to assist a patient • Transferring into a car when he or she is discharged from the hospital • If you are working in the patient’s home • It may be your responsibility to assist the patient when going in and out of a car

  26. Manual Wheelchair to Car Tips Tip #1 Keep the sitting surfaces equal. Tip #2 Remember friction in physics? - lessen the friction involved. Tip #3 Slide the car seat all the way back AND... Tip #4 Instead of wedging yourself in the crux of the door and the car... Tip #5 The steering wheel is a sturdy "grab bar" - use it wisely. Tip #6 Pull instead of push.

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