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CHAPTER OBJECTIVES

CHAPTER OBJECTIVES

At the completion of this chapter, the reader will be able to:

  1. Understand the importance of choosing the most efficient and safest method of transfer and mobility task

  2. Determine the best transfer or mobility procedure based on the level of patient dependence or independence

  3. Discuss the importance of patient safety during transfers and mobility tasks

  4. Discuss the importance of clinician safety during transfers and mobility tasks

  5. Transfer a patient to and from many different types of surfaces

  6. Perform a variety of mobility tasks

  7. Describe the various wheelchair components and their functions

  8. Measure a patient for a wheelchair

  9. Train a patient in how to use a wheelchair

OVERVIEW

A transfer can be viewed as the safe movement of a person from one place or surface to another and an opportunity to train an individual to enhance independent function. In both cases, the clinician must choose the most efficient and safest method.

Controlling a patient’s movement while moving them from one position or surface to another or preventing a patient from falling requires that the clinician be close to the patient’s center of motion (COM), which is typically located between the shoulders and the pelvis. When these control points are used, patient transfers are more efficient, and patient safety is enhanced. The most efficient way to enhance the patient’s movement (unless they are completely dependent) is to encourage movement of the body’s distal component—the part of the body farthest from the trunk. For example, when assisting a patient to stand from a seated position, a common verbal cue is to ask the patient to lean their trunk forward. It is also important to have the patient look in the direction of the transfer’s destination to encourage correct head-turning.

PATIENT TRANSFERS

One of the main purposes of transfers is to permit a patient to function in different environments and increase their independence level. Several moving and lifting devices (total body lifts and sit-to-stand lifts) have been designed and incorporated into the healthcare system because of advancements in recent years. However, because of the expense and sometimes the inconvenience of these devices, manual transfers continue to be commonly used. In these cases, the best body mechanics possible should be used to maximize the ability to encompass a task with minimal effort and maximum safety (see Chapter 7). It is important to note that certain transfers increase the risk for injury (Table 10-1), necessitating additional care and attention. Depending on the patient’s functional ability, a transfer may be performed independently by the patient, with assistance from the clinician (minimal, moderate, maximal, or standby supervision) or dependently (Table 10-2).

TABLE 10-1Transfer Techniques and Their Risk for Injury from the Least to Most Stressful

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