As a certified nursing assistant, you are very hands on with your client. You are responsible for the very basic needs of your client including his or her mobility. As the primary caregiver of the client, one of your duties is the safety of your clients when transferring them from bed to chair, bed to stretcher and vice versa. Strength is not only necessary, but also the proper and safe transfer techniques so you’ll not be physically strained. Proper transferring will not only benefit your client, but also yourself.
Before the transfer, here are the general considerations a CNA can follow:
- Plan the transfer well. Determine the sequence, space used, number of assistants necessary, the skill and strength of the CNA, and the assessment of the client’s capabilities and tolerance.
- Make sure your equipment is complete and ready and safe to use.
- Remove unnecessary obstacles from the area used for transfer.
- Explain the transfer to the client and assisting personnel, including specific directions of their participation.
- Always support and hold the client, rather than the equipment.
- During the transfer, explain to the client what he or she should do step by step.
For the equipments to be used, the CNA may keep this in mind:
- Walking belts for transfer provide the greatest safety since the CNA can grasp the belt to control the movement of the client during the transfer.
- Slings, lapboards, bath blankets, pillows and nonskid shoes may help in facilitating efficient and effective transfer.
- For bed to wheelchair transfer, position the chair parallel or on a 45 degree angle to the bed, depending the ability to walk of the client. Ensure that the wheelchair’s brakes are locked, the footplates are removed, and the bed brakes are also locked.
- For bed to stretcher transfer, position stretcher parallel to the bed, lock the stretcher and the bed brakes.
- For a mechanical or hydraulic lift, use a frame, canvas strips or chains, and a hammock or canvas strips.
- Assuming that the client is capable of sitting, place the bed in the lowest position with the client’s feet resting flat on the floor.
- Ask or assist the client to: move, sit at the edge of the bed, slightly lean forward from the hips, place the stronger foot beneath the edge of the bed, and the other foot forward. Place the client’s hand on the bed or on the CNA’s shoulder to push while standing.
- The can stands directly in front of the client, leans forward from the hips, knees and ankles, and assumes a broad stance, placing one foot forward and one foot back.
- Encircle client’s waist with arms and grasp the transfer belt at the back.
- Assist client to stand and move together toward the wheelchair.
- Assist the client to sit. Ensure that the client’s legs are placed against the chair.
- Secure client’s safety. The back of the client must rest well on the chair, feet are on lowered footplates and seat belt is applied as required.
- Lower the head of the bed until it is flat or until the client can tolerate.
- Raise the bed until it is slightly higher than the surface of the stretcher.
- Pull the drawsheet out from the both sides of the bed and roll it as close to the client as possible.
- Move the client to the edge of the bed and position it parallel to the bed.
- Transfer the client to the stretcher by asking the client to flex his neck and to place arms over his chest during the transfer. In unison, press the body against the stretcher, pull drawsheet against the client, flex hips, and pull client towards the CNA and the stretcher.
- Ensure client comfort and safety. Raise side rails and fasten safety straps.