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

Using a Gait / Transfer Belt to Assist the Resident to Ambulate

Walking (aka, ambulating) helps residents maintain mobility and independence, and prevents complications. However, ambulation must be done safely so that the resident does not have a fall or injury. A gait or transfer belt, when properly used, can increase resident safety. Gait belts can vary between facilities, so make sure you know how to use the one in your facility.

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.

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.

Measuring and Recording Output from a Urinary Drainage Bag

Accurate measurement of urination (aka, the output portion of intake and output) allows medical personnel to assess kidney and bladder function. Changes in output quantity or quality can reflect health status changes including new-onset infection or renal injury.

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?

Passive Range of Motion Exercises

Range of motion exercises are used to help prevent or decrease contractures, improve flexibility of joints, and improve strength [1]. Bedridden patients as well as those with reduced mobility may greatly benefit from passive range of motion exercises. However, do not perform these exercises without an order to do so, as it may be contraindicated in certain situations.