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Moving a patient from bed to a wheelchair

Pivot turn; Transfer from bed to wheelchair

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Description

Follow these steps to move a patient from bed to a wheelchair. The technique below assumes the patient can stand on at least one leg.

If the patient cannot use at least one leg, you will need to use a lift to transfer the patient.

Preparation

Think through the steps before you act and get help if you need it. If the patient is not able to stand, take small steps, and support their body weight, you should get help.

Make sure any loose rugs are out of the way to prevent slipping. You may want to put non-skid socks or shoes on the patient's feet if the patient needs to step onto a slippery surface.

The following steps should be followed:

• Explain the steps to the patient.
• Park the wheelchair next to the bed, parallel or at a slight angle.
• Put the brakes on and move the footrests out of the way.

Getting a Patient Ready to Transfer

Before transferring into the wheelchair, the patient must be sitting.

Allow the patient to sit for a few moments, in case the patient feels dizzy when first sitting up.

The following steps should be followed when getting ready to transfer a patient:

• To get the patient into a seated position, roll the patient onto the same side as the wheelchair.
• Put one of your arms under the patient's shoulders and one behind the knees. Bend your knees.
• Swing the patient's feet off the edge of the bed and use the momentum to help the patient into a sitting position.
• Move the patient to the edge of the bed and lower the bed so the patient's feet are touching the ground.

Pivot Turn

If you have a gait belt, place it on the patient to help you get a grip during the transfer. During the turn, the patient can either hold onto you or reach for the wheelchair. They should not wrap their arms around your head or neck.

Stand as close as you can to the patient, reach around the chest, and lock your hands behind the patient or grab the gait belt.

The following steps should be followed:

• Place the patient's outside leg (the one farthest from the wheelchair) between your knees for support. Bend your knees and keep your back straight.
• Count out loud to three and slowly stand up. Use your legs to lift and shift your weight from your front leg to your back leg.
• At the same time, the patient should place their hands by their sides and help push off the bed.
• The patient should help support their weight during the transfer.
• Pivot towards the wheelchair, moving your feet so your back is aligned with your hips.
• Once the patient's legs are touching the seat of the wheelchair, bend your knees and move your weight from your back to your front leg to lower the patient into the seat. At the same time, ask the patient to reach for the wheelchair armrest.

If the patient starts to fall during the transfer, lower the person to the nearest flat surface, bed, chair, or floor.

References

Bergman R, De Jesus O. Patient care transfer techniques. [Updated 2022 Oct 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. www.ncbi.nlm.nih.gov/books/NBK564305. Accessed June 14, 2024.

De Jong MR. Essentials of patient care for the sonographer. In: Hagen-Ansert S, ed. Textbook of Diagnostic Sonography. 9th ed. St Louis, MO: Elsevier; 2023:chap 2.

Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Body mechanics and positioning. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2016:chap 12.

Review Date: 10/28/2023  

Reviewed By: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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