Chapter 20: "Transferring the Person" (PART II; pp. 296-307)

Using bathroom for elimination promotes:

• Privacy

• Dignity

• Self-esteem

• Independence

​

However, bathrooms are often small = little room for CNA & w/c

• Falls & work-related injury are risks​

​

(pp. 296-297)

Transferring the Person to and from the Toilet

<-- Use procedure if person can stand & pivot from w/c to toilet

​

May require:​

• Transfer board (p. 298)

• Mechanical lift (p. 300)

​

(pp. 296-297)

Multiple Choice

The CNA is transferring a patient from the wheelchair to the toilet. Which is correct?

• The CNA should make sure the toilet has a short toilet seat.

• The CNA should not transfer the person if the grab bars by the toilet are not secure.

• The person should wear soft, warm, and comfortable bedroom slippers.

• The CNA should unlock the w/c wheels right before transferring the person.

Lateral Transfer -> moves person between 2 horizontal surfaces.

• E.g. Transfer from bed to stretcher

• E.g. Transfer from bed to shower trolley (Ch. 24)

​

Friction-reducting devices protect pt's skin during lateral transfers & staff from injury

• Friction & shearing (Ch. 19) of skin

• Infection & pressure injuries (Ch. 41)​

​

(pp. 298-299)

Lateral Transfers

Lateral transfer devices include:

• Lift, turning, or drawsheet

• Turning pad

• Large, re-usable waterproof under-pad

• Slide sheet or other lateral sliding aid (Fig. 20-13; previous slide)

Transfer ("sliding") board​ used for seated lateral transfers if: (Fig. 20-14)

• Person has upper body strength

• Person has good sitting balance

• Enough room to position 2 surfaces close together​

​

(pp. 298-299)

Friction-reducing devices + at least 2-3 staff members required for safe transfer to/from stretchers

If pt weighs less than 200 lbs, use:

• ​Friction-reducing device -or-

• Lateral transfer device ("sliding aid")

If pt weighs more than 200 lbs, use:

• Lateral transfer device, mechanical ceiling lift (p. 300), or other device

• At least 3 staff members!​

​

(pp. 298-299)

​Moving the Person to a Stretcher

If pt has bariatric needs, RN & care plan may direct staff to:

• Use bariatric stretcher & check for EC ("expanded capacity")

• Position stretcher 1/2 inch lower than bed

• Use lateral transfer device, bariatric ceiling lift (p. 300), or other as directed​

• Transfer pt from his/her strong side​

• Apply abdominal binder if pt's abdomen is in the way (Ch. 40)​

​

(pp. 298-299)

Multiple Choice

You need to laterally transfer a resident to a stretcher. Which is correct?

• Ask one co-worker to help you.

• Lower the bed to its lowest level.

• Use a friction-reducing device.

• Make sure bed rails are raised.

Multiple Choice

TRUE or FALSE:

A transfer board may be used for a seated lateral transfer if the person has good upper body strength.

• TRUE

• FALSE

Range-of-Motion Exercises:

PROM (Ch. 34 - Exercise & Activity)​

​

(pp. 535-539)

Range of Motion (ROM) -> movement of a joint to the extent possible w/o causing pain​

• ROM exercises at least 2 times/day​

  • Pts on bedrest require more frequent ROM exercises​

  • Pts who cannot walk, turn, or transfer self d/t illness or injury​

• Eating, bathing, hair care, reaching, dressing/undressing​, ambulation, etc.

​

​

(pp. 535-539)

​ROM Exercises

• ​Active

  • ROM exercises are performed by the person

• Passive

  • CNA/RN moves person's joints through their ROM

• Active-Assistive

  • ​ROM exercises performed by person, but with some help

​

(pp. 535-539)

​The 3 Types of

ROM Exercises​

​

PROM Practice

(see pages 538-539)

PROM Practice

(see pages 538-539)

PROM Practice

(see pages 538-539)