Moving the client in & out of bed Presented by: Miss: Nourah al-khaledi.

Moving the client in & out of bed

Presented by:Miss: Nourah al-khaledi.

Fundamentals Of Nursing

OBJECTIVES:

1. Definition of transferring.2. Discuss the reasons of transferring .3. Mention Methods of transferring.4. Discuss the action applicable to moving and

lifting client before moving a client5. Mention required equipment.6. Demonstrate the steps of each procedure .

Definition of transferring:

Moving a patient from place( refer to moving a patient from bed to a chair or stretcher or wheelchair with maximum comfort and safety for patient and nurse.

Improvement of the patient condition (from ICU to medicine unit).

Worsen of patient condition (to ICU). The need for surgery or x-ray . Transfer at the patient request.

Reasons for transferring:

Change position . Reposition the client. Client slide down in bed from fowlers

position. Changing the bed linen.

Reason for moving:

Wheelchair. Stretcher. Movable bed.

Methods of transferring:

1-Assess: The client physical abilities. Ability to understand instructions. Degree of comfort or discomfort when

moving.

Action applicable to moving and lifting client before

moving a client…

Client weight. Presence of orthostatic hypotension. You own strength and ability to move the

client.

Continue

2-if indicated ,use pain relief modalities or medication prior moving the client.

3-preper support equipment (pillow ).4-obtain required assistance .5-explain the procedure to the client and

listen to any suggestions the client.6-provide privacy .7-wash hands.

Continue.

8- rise the height of the bed to bring the client close to your center of gravity .

9-lock the wheels on the bed and raise the rail on the side of the bed opposite you to ensure client safety.

10-face in the direction of the movement to prevent spinal twisting .

Continue.

PROCEDURE

Assist client to sit on side

of bed

Assist client to move up

in bed

Transferring between bed

and chair

Logrolling client

Transferring between bed and

stretcher

Equipment : Pillows. Side rails. Draw sheet.

Purposes: To promote the client’s comfort.

Moving client up in bed

Performance: ◦Explain to the client and listen for his

questions.◦Wash hands and provide privacy .◦Lower head of the bed and raise the bed

to your center of gravity .◦ lock the wheels and raise the side rail

opposite to you.

Moving client up in bed

Performance cont:

◦Remove the pillows and place one only against the head of the bed

◦Ask client to flex hips and knees and position feet so that they can be used for pushing .

◦Ask client to :-A. Grasp the head of the bed with both

hands and pull during move or B. Raise upper part of body on elbows

and push with hands and forearm during the move.

Two people required to move clients who are unable to assist because of their condition or weight.

The second staff member on the opposite side of bed, both of you interlock your forearm under clients thighs and shoulders and lift client up in bed.

Two nurses using a hand interlock

Purpose: before walking, moving to chair, eating or performing other activates.

Performance :◦Assist client to lateral position

facing you .◦Raise head of bed slowly to

highest position.

ASSISTING CLIENT TO SIT ON SIDE OF BED

Place a draw sheet or a full sheet folded in half under the client, extending from the shoulders to the thighs.  

Each person rolls up or fanfolds the turn sheet close to the client’s body on either side. 

Both individuals grasp the sheet close to the shoulders and buttocks of the client.  

Follow the method of moving clients with limited upper extremity strength, as described earlier.

Two Nurses Using a Turn Sheet

Purpose:

The client assumes a sitting position on the edge of the bed before walking , moving to a chair , eating, or performing other activities.

Assisting client to sit on side of bed

◦Stand beside clients hips and face far corner of bed

◦Lean your trunk forward and flex your hips , knees and ankles

◦Move client to sitting position (place one arm around client shoulder and other beneath both clients thigh near knees

◦Lift client thighs slightly.

Assisting client to sit on side of bed

◦Pivot on balls of your feet in desired direction facing foot of bed while pulling client feet and legs off bed ( prevent twisting of nurse supine).

◦Support client well ( this movement may cause some clients to faint ).

◦Assess vital signs as indicated by clients health status.

continue

Purpose: to turn client whose body most all times be kept in straight alignment .

Performance:◦Stand on the same side of bed and broad

base of support with on foot ahead of other.

◦Place clients arms across chest.◦Lean your trunk and flex your hips knees

and ankles.

Logrolling client

◦Place your arm under client. ◦Pull client to the side of the bed .◦Move to the other side and place

supportive devices.◦Roll and position clients in proper

alignment.

Logrolling

Equipment : appropriate clothes and slipper –transfer belt .

Preparation :◦ Plan of what to do and how to do it. ◦ Obtain equipment and check for function well.◦ Remove obstacles from areas.

Performance:◦ Place wheelchair parallel to bed as close as

possible and lock the wheels and raise the foot plate .

TRANSFARING BETWEEN BED AND CHAIR

◦ Assist client to sitting position on side of bed .◦ Place transfer belt around the waist of clients.◦ Ask client to:

move forward and sit on the edge of bed. lean forward slightly from hips. Place strong foot beneath edge of bed and the other

forward .◦ Place client hands on bed surface or on your

shoulders( so they can push while standing ).◦ Mirror the placement of the clients feet (prevent

loss of balance during transfer).

continue

Encircle clients waist with your arms and grasp the belt at client back..

Assist the client to stand, and then move together toward the wheelchair.

Assist the client to sit.

continue

Ask the client to:◦Back up to the wheelchair and place the legs

against the seat.◦Place the foot of the stronger leg slightly behind

the other.◦Keep the other foot forward◦Place both hands on the wheelchair arms or on

your shoulders.◦Ask the client to push back into the wheelchair

seat.◦Lower the footplates, and place the client’s feet

on them.

continue

Performance:◦ Lower the head of the bed .◦ Raise the bed slightly higher than the stretcher

(easier for client to move down ).◦ Pull draw sheet out from both sides of bed .◦ Place the stretcher parallel to bed and fill the gap

with blankets.◦ Roll the sheet against client ,flex hips and pull onto

stretcher.◦ Ask client to flex neck and place arms across chest. ◦ Ensure clients comfort and raise the side rails of

stretcher .

TRANSFERRING BETWEEN BED AND STRETCHER

Document all relevant information:- ◦Time and change of position moved from

and position moved to.◦Any signs of pressure areas.◦Use of support devices.◦Ability of client to assist in moving and

turning.◦Response of client to moving and

turning.

Documentation

Fundamentals of nursing concepts ,process and practice,7th edition written by kozier 2005

Nurses guide to clinical procedures 5th edition written by jean smith temple and Joyce young Johnson 2007

http://www.rehabpub.com/features/892005/3.asp http://www.independentliving.co.uk/manual-handl

ing.html

References

THANK YOU