Nursing & Healthcare Programs

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

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.

Handwashing for CNAs

Handwashing is considered the single most important practice to prevent the spread of infection. Even when hands look clean, they could potentially be crawling with dangerous microorganisms and pathogens. Using soap and friction during handwashing helps loosen the oils on the skin, allowing dirt and pathogens to be rinsed away.

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.

Nail Care (Fingers and Toes) for CNAs

Nail care of both the feet and the hands should be performed as part of the patient’s daily hygiene routine. The status of the patient’s nails can reflect their overall health. Nail issues can also lead to infection that can spread systemically (ex, ingrown nails or fungus). You should never clip a patient’s nails with nail clippers, and always review your institution’s policy about what nail care is allowed.

Measuring the Radial Pulse

The radial artery, located in the wrist, is easy to feel and an efficient location to measure heart rate. Changes to the rhythm or strength of the radial pulse can indicate heart disease, damage to the arm, or body fluid status. It is important to remember to check the radial pulse on both sides as differences between left and right can indicate injury or disease processes.