TRANSFERRING A PATIENT FROM THE BED TO A STRETCHER
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Added: May 11, 2023
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TRANSFERRING A PATIENT FROM THE BED TO A STRETCHER FARRAH ROSE MAY I. LEE, RN
While in the hospital, patients are often transported by stretcher to other areas for tests or procedures . Considerable care must be taken when moving someone from a bed to a stretcher or from a stretcher to a bed to prevent injury to the patient or staff.
EQUIPMENT • Transport stretcher • Friction-reducing sheet • Lateral-assist device, such as a transfer board, roller board, or mechanical lateral-assist device, If available • Bath blanket • Regular blanket • At least two assistants, depending on the patient’s condition • Nonsterile gloves and/or other PPE, as indicated
ASSESSMENT Review the medical record and nursing plan of care for conditions that may influence the patient’s ability to move or to be transferred. Assess for tubes, IV lines, incisions, or equipment that may alter the transfer process. Assess the patient’s level of consciousness, ability to understand and follow directions, and ability to assist with the transfer. Assess the patient’s weight and your strength to determine if a fourth individual (or more) is required to assist with the activity. Assess the patient’s comfort level; if needed, medicate as ordered with analgesics
NURSING DIAGNOSIS • Activity Intolerance • Acute Pain • Anxiety • Risk for Impaired Skin Integrity • Risk for Falls • Impaired Transfer Ability
OUTCOME IDENTIFICATION AND PLANNING The expected outcome to achieve when transferring a patient from the bed to a stretcher is that the patient is transferred without injury to patient or nurse
IMPLEMENTATION 1. Review the medical record and nursing plan of care for conditions that may influence the patient’s ability to move or to be positioned. Assess for tubes, IV lines, incisions, or equipment that may alter the positioning procedure. Identify any movement limitations. Consult patient handling algorithm, if available , to plan appropriate approach to moving the patient. 2 . Perform hand hygiene and put on PPE, if indicated. 3 . Identify the patient. Explain the procedure to the patient 4. Close curtains around bed and close the door to the room, if possible. Adjust the head of the bed to a flat position or as low as the patient can tolerate. Raise the bed to a height that is even with the transport stretcher (VISN 8 Patient Safety Center, 2009). Lower the side rails, if in place. 5. Place the bath blanket over the patient and remove the top covers from underneath.
6. If a friction-reducing transfer sheet is not in place under the patient, place one under the patient’s midsection. Have patient fold arms against chest and move chin to chest. Use the friction-reducing sheet to move the patient to the side of the bed where the stretcher will be placed. Alternately, place a lateral-assist device under the patient. Follow manufacturer’s directions for use. 7 . Position the stretcher next to (and parallel) to the bed. Lock the wheels on the stretcher and the bed. 8 . Two nurses should stand on the stretcher side of the bed. A third nurse should stand on the side of the bed without the stretcher . 9. Use the friction-reducing sheet to roll the patient away from the stretcher (Figure 2). Place the transfer board across the space between the stretcher and the bed, partially under the patient (Figure 3). Roll the patient onto his or her back, so that the patient is partially on the transfer board
10. The nurse on the side of the bed without the stretcher should grasp the friction-reducing sheet at the head and chest areas of the patient. One nurse on the stretcher side of the bed should grasp the friction-reducing sheet at the head and chest, and the other nurse at the chest and leg areas of the patient . 11. At a signal given by one of the nurses, have the nurses standing on the stretcher side of the bed pull the frictionreducing sheet. At the same time, the nurse (or nurses) on the other side push, transferring the patient’s weight toward the transfer board, and pushing the patient from the bed to the stretcher (Figure 4 ). 12. Once the patient is transferred to the stretcher, remove the transfer board, and secure the patient until the side rails are raised. Raise the side rails (Figure 5). To ensure the patient’s comfort, cover the patient with blanket and remove the bath blanket from underneath. Leave the friction-reducing sheet in place for the return transfer
EVALUATION The expected outcome is met when the patient is transferred to the stretcher without injury to patient or nurse.