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Transferring a Patient from Bed to Wheelchair

Overview: To promote safety, prevent injury, and maintain correct body alignment.

Preparation
● Check prescriber’s orders for specific restrictions regarding patient activity and positioning.
● Assess patient’s ability and motivation to assist.
● Determine patient’s and/or caregiver’s ability to understand and follow instructions.
● Assess joint mobility and muscle strength of extremities.
● Determine presence and location of any equipment and tubing.

Special Considerations
• Some patients may need analgesic medication to enhance comfort prior to moving.

Elderly, Pediatric, Confused, and Physically or Mentally Challenged Patients
• May require more time, teaching, and assistance.
• Involve family and/or caregiver in teaching of this procedure.
• Monitor activity while in wheelchair.
• Use seat belts/special restraint devices that fasten behind the wheelchair to protect from sliding down and falling.

Relevant Nursing Diagnoses
● Impaired physical mobility related to trauma, surgery, or neuromuscular deficit
● Pain/discomfort related to inability to tolerate moving, sitting, and/or standing
● Self-care deficit related to mental and/or physical impairment

Expected Outcomes
● Patient will be transferred from bed to wheelchair without injury and with minimal or no discomfort
● Patient and/or caregiver will be able to assist with the procedure

Equipment/Supplies
Wheelchair, Clean gloves, Any other personal protective equipment as needed

Implementation
1. Explain procedure to patient and significant others.
Rationale: Reduces anxiety and enhances participation.

2. Wash hands and don gloves.
Rationale: Reduces spread of microorganisms.

3. Close door or curtain.
Rationale: Provides for privacy.

4. Assist patient to put on robe and non-slippers or shoes.
Rationale: Promotes safety by reducing the risk for falls and injury.

5. Place bed in lowest position.
Rationale: Facilitates transfer to wheelchair.

6. Position the wheelchair as close as possible to the bedside facing the foot of the bed. When sitting at side of bed, patient should be able to steady self by using the hand on the unaffected side to grasp the arm of the wheelchair.
Rationale: Facilitates use of stronger side to provide balance and improve stability during transfer.

7. Lock wheels of bed and wheelchair. Raise foot pedals on wheelchair.
Rationale: Promotes patient safety.

8.Raise head of bed to highest position.
Rationale: Decreased expenditure of energy.

9. Assist patient to sitting position on side of bed by supporting patient’s head and neck while moving patient’s legs over edge of the bed to dangle. Steady patient in this position for a few minutes.
Rationale: Facilitates transfer to the wheelchair and allows circulatory system to adjust to change in position (reduces risk for postural hypotension).

10. To assist patient to standing position, face patient and brace your feet and knees against the patient (especially against the patient’s affected extremity).
Rationale: Promotes stability and use of unaffected extremities to facilitate movement.

11. Pivot the patient (on unaffected limb if applicable) toward seat of chair with legs positioned against the chair.
Rationale: Enhances patient’s sense of security and ensures proper position before sitting.

13. The patient may use one arm (the unaffected limb if applicable) to place on the arm of the wheelchair while slowly easing self to sitting position in wheelchair.
Rationale: Ability to use own arm provides support and stability for patient.

14. Continue to brace patient’s knees with your knees and flex your hips and knees when lowering patient to sitting position.
Rationale: Reduces potential for strain on the nurse’s back.

15. Adjust or support patient’s position with pillows where necessary.
Rationale: Promotes proper body alignment and comfort.

16. Place call light within reach.
Rationale: Promotes patient safety.

17. Remove gloves and other protective equipment, and wash hands.
Rationale: Reduces spread of microorganisms.

Evaluation and follow up activities
● Assess patient’s tolerance of activity
● Assess patient’s ability to transfer safely
● Reinforce teaching
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