Can a Patient Request to Be Transferred to Another Hospital

Chapter 3. Prophylactic Patient Handling, Positioning, and Transfers

3.seven Patient Transfers

Transfers are divers equally moving a patient from ane flat surface to some other, such as from a bed to a stretcher (Perry et al., 2014). Types of hospital transfers include bed to stretcher, bed to wheelchair, wheelchair to chair, and wheelchair to toilet, and vice versa.

Patient Transfer from Bed to Stretcher

A bed to stretcher transfer requires a minimum of three to four people, depending on the size of the patient and the size and strength of the health care providers. Patients who require this type of transfer are generally immobile or acutely ill and may be unable to assist with the transfer. Checklist 29 shows the steps for moving patients laterally from 1 surface to another.

Checklist 29: Moving a Patient from Bed to Stretcher

Disclaimer: Always review and follow your hospital policy regarding this specific skill.
Safety considerations: Perform paw hygiene. Check room for additional precautions. Introduce yourself to patient. Confirm patient ID using 2 patient identifiers (e.g., name and date of nascency). Listen and attend to patient cues. Ensure patient'southward privacy and nobility. Appraise ABCCS/suction/oxygen/safety. Ensure tubes and attachments are properly placed prior to the procedure to prevent accidental removal. A slider board and full-size sheet or friction-reducing sheet is required for the transfer.
Steps		Additional Data
one. Always predetermine the number of staff required to safely transfer a patient horizontally.		Three to four wellness intendance providers are required for the transfer.
2. Explain what will happen and how the patient tin help (tuck chin in, go on hands on chest). Collect supplies.		This step provides the patient with an opportunity to ask questions and aid with the transfer. Stretcher and slider board Chin tucked in and artillery across chest
3. Raise bed to safe working height. Lower head of bed and side rails. Position the patient closest to the side of the bed where the stretcher will be placed.		Safe working height is at waist level for the shortest health care provider. The patient must be positioned correctly prior to the transfer to avoid straining and reaching. May need additional wellness care providers to move patient to the side of the bed.
iv. Whorl patient over and place slider board halfway nether the patient, forming a bridge between the bed and the stretcher. Place sheet on top of the slider board. The sheet is used to slide patient over to the stretcher. The patient is returned to the supine position. Patient's feet are positioned on the slider lath.		The slider board must be positioned as a bridge between both surfaces. The canvass must be betwixt the patient and the slider board to decrease friction betwixt patient and board. Identify slider board Ensure all tubes and attachments are out of the way.
5. Position stretcher beside the bed on the side closest to the patient, with stretcher slightly lower. Apply brakes. Ii health care providers climb onto the stretcher and grasp the canvas. The lead person is at the head of the bed and volition grasp the pillow and canvass. The other health care provider is positioned on the far side of the bed, betwixt the chest and hips of the patient, and will grasp the sheet with palms facing up. The two caregivers on the stretcher grasp the draw sheet using a palms up technique, sitting upward tall, and keeping their elbows close to their trunk and backs straight.		The position of the health care providers keeps the heaviest part of the patient near the health care providers' eye of gravity for stability. Caregiver at the head of the bed
half dozen. The caregiver on the other side of the bed places his or her hands under the patient's hip and shoulder expanse with forearms resting on bed.
seven. The designated leader volition count i, 2, 3, and start the move. The person on the far side of the bed will push patient just to arm's length using a back-to-front weight shift. At the same time, the two caregivers on the stretcher will move from a sitting-upward-tall position to sitting on their heels, shifting their weight from the front leg to the dorsum, bringing the patient with them using the sheet.		Coordinating the motion betwixt health intendance providers prevents injury while transferring patients. Using a weight shift from front to dorsum uses the legs to minimize effort when moving a patient.
8. The two caregivers will climb off the stretcher and stand up at the side and grasp the sail, keeping elbows tucked in. One of the two caregivers should exist in line with the patient'south shoulders and the other should be at the hip area. On the count of 3, with back straight and knees bent, the ii caregivers apply a front-to-back weight shift and slide the patient into the middle of the bed.		The pace allows the patient to be properly positioned in the bed and prevents back injury to health care providers. Caregiver at the head of the bed Weight on front leg Shift weight to back human foot
9. At the same fourth dimension, the caregiver on the other side slides the slider board out from under the patient.		This stride allows the patient to lie apartment on the bed.
ten. Supersede pillow under head, ensure patient is comfy, and embrace the patient with sheets.		This promotes comfort and prevents damage to patient.
eleven. Lower bed and lock brakes, raise side rails as required, and ensure call bell is within reach. Perform mitt hygiene.		Placing bed and side rails in a condom position reduces the likelihood of injury to patient. Proper placement of call bell facilitates patient's ability to ask for assist. Bed in lowest position, side rails up, telephone call bell within reach Hand hygiene reduces the spread of microorganisms. Hand hygiene with ABHR
Data source: ATI, 2015c; Perry et al., 2014; PHSA, 2010

Take this Lateral Transfer Sliding Lath course for more information on sliding board transfer.

Transfer from Bed to Wheelchair

Patients often demand assistance when moving from a bed to a wheelchair. A patient must exist cooperative and predictable, able to bear weight on both legs and take small steps. If any of these criteria are not met, a two-person transfer or mechanical lift is recommended. Always complete a patient hazard assessment prior to all patient-handling activities. See Checklist 30 for the steps to transfer a patient from the bed to the wheelchair (PHSA, 2010).

Checklist 30: Bed to Wheelchair Transfer

Disclaimer: E'er review and follow your hospital policy regarding this specific skill.
Safety considerations: Check room for additional precautions. Introduce yourself to patient. Confirm patient ID using two patient identifiers (e.g., name and date of birth). Listen and attend to patient cues. Ensure patient'due south privacy and dignity. Appraise ABCCS/suction/oxygen/rubber. Ensure tubes and attachments are properly placed prior to the procedure to prevent accidental removal. A gait belt and wheelchair are required.
Steps		Additional Information
1. Ane health care provider is required.		The patient should be assessed as a one-person assistance.
ii. Perform mitt hygiene. Explicate what volition happen during the transfer and how the patient tin can help. Use proper footwear prior to ambulation		This step provides the patient with an opportunity to inquire questions and help with the positioning. Explain process to patient Proper footwear
three. Lower the bed and ensure that brakes are applied. Place the wheelchair side by side to the bed at a 45-degree angle and use brakes. If a patient has weakness on one side, identify the wheelchair on the strong side.		Ensure brakes are applied on the wheelchair. Wheelchair with one leg rest removed
4. Sit patient on the side of the bed with his or her feet on the floor. Apply the gait chugalug snugly around the waist (if required). Place easily on waist to assist into a continuing position		The patient's feet should be in betwixt the health intendance provider'southward feet. Patient position prior to standing
5. As the patient leans forward, grasp the gait belt (if required) on the side the patient, with your artillery outside the patient's arms. Position your legs on the outside of the patient's legs. The patient's feet should be flat on the floor.		Assistance to a continuing position using a gait belt
half dozen. Count to three and, using a rocking motion, help the patient stand by shifting weight from the front foot to the back pes, keeping elbows in and back straight.		Weight shift to back leg by health care provider
seven. One time standing, have the patient accept a few steps back until they tin can feel the wheelchair on the back of their legs. Accept patient grasp the arm of the wheelchair and lean forward slightly.		Ensure the patient can feel the wheelchair on the back of the legs prior to sitting downwards. Assist into the wheelchair
8. As the patient sits downwardly, shift your weight from back to front with bent knees, with torso straight and elbows slightly bent. Let patient to sit in wheelchair slowly, using armrests for support.		This allows the patient to exist properly positioned in the chair and prevents back injury to health care providers. Transfer to wheelchair
Information source: ATI, 2015b; Perry et al., 2014; PHSA, 2010

Special considerations:

• Practice not allow patients to place their artillery effectually your neck. Have them place their arms around your hips.
• Avert lifting patients. Let them stand using their ain force.
• Stay close to your patient during the transfer to keep the patient's weight close to your heart of gravity
• If the patient has weakness on one side of the trunk (eastward.grand., due to a cognitive vascular accident — CVA — or stroke), place the wheelchair on the potent side.

Video 3.6

Take this Continuing Step Around Transfer course to larn the method for a bed to wheelchair transfer.

1. Prior to moving the patient, where should the patient'south feet exist placed?
2. As you start to stand up your patient, the patient gently places his artillery around your neck. How practice you lot proceed?

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Source: https://opentextbc.ca/clinicalskills/chapter/3-7-transfers-and-ambulation/

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