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Assisting the Resident to Transfer from the Bed to a Chair or Wheelchair

Written by Hollie Finders, RN
Hollie Finders is a registered nurse with years of experience working in the health care field. She has degrees in both biochemistry and nursing. After working with patients of all ages, Hollie now specializes in pediatric intensive care nursing. Hollie’s LinkedIn

Procedure

Equipment needed: gait belt, non-skid footwear, and chair or wheelchair.

  1. Perform hand hygiene.
  2. Explain the procedure to the resident and ask for his or her assistance in following directions.
  3. Place a chair or wheelchair right next to the bed on the resident’s unaffected side. The chair should be at the head of the bed and facing the foot of the bed.
  4. Lock the wheels of the chair or wheelchair if applicable.
  5. Assist the resident in sitting on the side of the bed. Raise or lower the bed so the resident’s feet are flat on the floor. Apply non-skid footwear to the resident’s feet.
  6. If available, fasten a gait belt securely around the resident’s waist.
  7. Stand in front of the resident and assume a proper lifting position. Align your legs with the resident’s legs to prevent him or her from slipping.
  8. If using a gait belt, firmly grasp the belt on both sides of the resident. If no gait belt is available, wrap your arms around the resident’s torso, keeping his or her arms free.
  9. Ask the resident to stand while supporting his or her movement. You may instruct the resident to push off the bed to assist in standing.
  10. Instruct the resident to take small, slow steps toward the chair. Have the resident pivot so that the backs of his or her legs are touching the chair.
  11. Tell the resident to reach backward and grab the chair’s armrests. Then, gently lower the resident into the chair as he or she sits down.
  12. Ensure the resident’s bottom is all the way back in the chair. Align the resident’s body and support with pillows, if needed.
  13. Remove the gait belt.
  14. Attach footrests to the wheelchair if needed, or raise the footrest on the chair if desired.
  15. Transport the resident by wheelchair or place the call light within the resident’s reach.
  16. Perform hand hygiene.
  17. Document the procedure in the resident’s chart and report any changes in the resident’s condition to the nurse.

Important Information

It is important to remember on which side to place the chair when assisting a patient in transferring. Putting the chair on the resident’s unaffected side allows the resident to lead with his or her strong extremity. This eases the procedure for the resident and reduces the risk of falling [1].

A gait belt should always be used when available and appropriate for the resident’s condition. A gait belt is not used for lifting, but instead is used to help guide a resident’s movements [1]. Gait belts also give the health care worker something to hold onto while the resident transfers and can be used to help lower the resident to the floor if he or she begins to fall.

References

1. Guidelines for Nursing Homes

More Resources

Transferring the Resident from a Bed with a Mechanical Lift

A mechanical lift is used to transfer residents who cannot support their own weight. When used properly, mechanical lifts prevent injuries for both residents and health care workers. It is important that a nurse’s assistant be trained to use the mechanical lift before attempting to operate it. Most facilities require at least two health care workers to assist when using a mechanical lift.

Measuring Blood Pressure

Many factors can interfere with obtaining an accurate blood pressure. The most common mistakes that lead to inaccurate blood pressures are a result of improper technique, including: not supporting the patient’s arm, using the wrong sized cuff, positioning the cuff too low on the patient’s arm, improper positioning of the cuff’s artery marker, and attempting to measure blood pressure through clothing.

Making an Occupied Bed

If a patient is bedridden or on bedrest, the bed linens will need to be changed while the patient is in the bed. For safety reasons, the nurse’s aid should avoid making an occupied bed if the patient is able to get out of bed. Bed linens should be changed according to the facility’s policy or anytime they are wet or soiled.

Sim’s Position

The position a patient is placed in is often ordered by the physician, or recommended by a speech, occupational, or physical therapist. The position dictates whether a patient is sitting, lying, standing; or if they are on their side, back, or prone (face-down). Positioning is also determined by the patient’s current needs, such as: Are they eating? Sleeping? Having surgery on their back? Are they receiving nutrition through a nasogastric tube?

Removing Personal Protective Equipment

It is important to follow the correct procedure while removing personal protective equipment to avoid contaminating your skin or clothing. The most common source of contamination in this process stems from improper removal of gloves. Gloves are often the most soiled piece of equipment. To avoid contaminating your skin or the other equipment worn, gloves should always be removed first. Then remove the goggles, gown, and mask, in that order.

Moving the Resident to the Side of the Bed

Residents are usually kept in the center of the bed for safety reasons. However, moving a resident to the side of the bed is an important step to take before turning a resident onto his or her side. Performing this action allows the resident to end up side lying in the center of the bed and not smashed up against the side rail.

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