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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 you are not able to support the patient by yourself, you could injure yourself and the patient.

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, close to you.
• 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 to three and slowly stand up. Use your legs to lift.
• 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 on their good leg 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 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

American Red Cross. Assisting with positioning and transferring. In: American Red Cross. American Red Cross Nurse Assistant Training Textbook. 4th ed. American National Red Cross; 2018:chap 11.

Bergman R, De Jesus O. Patient care transfer techniques. [Updated 2021 Oct 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK564305.

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; 2017:chap 12.

Timby BK. Assisting the inactive client. In: Timby BK, ed. Fundamentals of nursing skills and concepts. 11th ed. Philadelphia, PA: Wolters Kluwer Health: Lippincott Williams & Wilkens; 2017:unit 6.

Review Date: 10/23/2021  

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

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