Transfers
Terms
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- Moderate Assistance
- Patient can complete some of the activity independently but completes no more than 50% of skill independently
- Independent
- Patient is consistently able to perform the activity safely
- Specialized Transfer Techniques
- Toilet, Tub, Car
- Factors to Consider
- Alsways let patient do as musch as possible, Three things must do: Lock wheelchair, Put gait belt on. MMT triceps and quads, Assess patients physiological state (chart review) or VSS, Check patient's sitting balance, Know patient's mental state and motivation, If at all in doubt, get assistance from aanother person
- Levels of Assistance
- Independent, Supervision, Stand by assist/close guarding. Contact guard assist, Minimal assistance, Moderate assistance, Maximal assistance
- Stand by assist/close guarding
- Fair probability of the patient needing assistance; helper should have a hand ready but not touching the patient
- Preparing Patient
- Place safety belt on patient, Tuck long robes out of way, Place foot coverings on patient, MMT quads and triceps, If patient has a non-functional UE, tuck it into the belt to protect it
- General Rules
- Body Mechanics, Factors to consider, Explanation of Process
- Types of Transfers
- 6 Person slide with draw sheet, 3 person lift without draw sheet, sliding board, swing pivot stand pivot/stand step
- Body Mechanics
- Keep paitent close to your body, Use your legs, Pivot your feet, don't twist, Maintain wide base of support
- Minimal Assistance
- Patient can complete the majority of the activity without assistance but requires up to 25% assistance from therapist
- After the Transfer
- Repsition patient, Assure modesty; drape patient as needed, Check medical devices for proper drainage; always make sure catheter is lower than the bladder and IC is higher than the insertion site
- Equipment
- Gait Belt, Sliding Board, Hoyer Lift
- Supervision
- Low probability of the patient having a problem performing the activity, but helper should be within arm's reach
- Toilet - Considerations
- Clothing should be loosened before transfer, Doors should be 26" or wider, Seat should be at least 20" high
- Perform Transfer
- Scoot patient to edge of chair, Count aloud to allow patient to prepare and assist, Move slowly, Use good body mechanics
- Toilet - Possible Transfer techniques
- Stand pivot, Forward or backward transfer, Swing pivot, Sliding board
- Contact Guard Assist
- High probability of patient needing assistance; helper should have hands on the patient, but not give assistance unless needed
- Explanation of Process
- Explain what you want the patient to do, what you are going to do, and what the assistant needs to do, Demonstrate the transfer to the patient
- Tub - Considerations
- Have patient sit on bench first and then swing legs in, Good to have grab bars, tub chair, rubber mats with no slip surface
- Toilet
- Need 5ft x 5ft area to do transfer
- Maximal Assistance
- Patient requires assistance from the therapist for at least 75% of the skill
- Tub & Car - Possible Transfer Techniques
- Stand pivot, Swing pivot, Sliding board