PREPARATION

1. Introduce self and verify the client's Introducing oneself and confirming the
identity using agency protocol. patient's identity establishes trust and
Explain to the 1 client what you are safety, ensuring the right patient is
going to do, why it is necessary, and being cared for.
how he or she can Participate.

2. Assess client's physiological motor Assessing the patient's physical and

and cognitive status. Determine if cognitive state helps determine the level
assistance would be needed from of assistance needed and ensures
other health care personnel patient safety.

3. Prepare all necessary equipment Gathering necessary equipment and

and supplies for the procedure. supplies ensures a smooth
transfer process without interruptions.

4. Perform hand hygiene and observe Maintaining hand hygiene and infection
other appropriate infection prevention protocols minimize the risk
prevention procedures. of spreading infections to both patients
and healthcare providers.

5. Provide privacy. Screen the Preserve the patient's dignity and

patients bed, close the door. complies with ethical and legal
standards

6. Adjust the bed and the client's Adjusting the bed and patient's position
position: guarantees a safe and comfortable
environment for the transfer.

a. Adjust the head of the Flattening the bed or adjusting it to the

bed to a flat position or client's tolerance prevents falls and
as low as the client can maintains stability during the transfer.
tolerate

b. Raise the bed to a height Raising the bed to an appropriate height

appropriate for reduces strain on healthcare personnel,
personnel safety. ensuring safe and ergonomic working
conditions.

c. Lock the wheels on the Locking the wheels and raising one
bed and raise the siderail prevent accidental movement
opposite siderail. during the transfer, enhancing patient
safety.
 d. Remove all pillows, then Placing a pillow against the head of the
place one against the bed supports the client's head and neck,
head of the bed. preventing discomfort and potential
injury.

7. Secure all of client's attachments. Ensuring all attachments are secured

prevents accidental dislodging during
the transfer.

8. Lower the siderails of the bed. Lowering the siderails enhances the
accessibility and safety of the patient for
the transfer.

PERFORMANCE
MOVING THE CLIENT UP IN THE BED (TWO PERSON)

9. Ensure client is in a supine position. Beginning with the patient in a supine

position ensures a stable base for the
transfer.

10. Place a draw sheet or friction- Placing a draw sheet or slide sheet
reducing slide sheet under the minimizes friction, reducing the risk of
client's back. skin shearing.

11. Face the head of the bed. Both of Standing at the head of the bed and
the nurses standing at the different communicating clearly ensure
sides of the bed with feet placed coordinated movement.
apart.

12. Place the client's arms across the Positioning the patient's arms across
chest. Ask the client to flex the neck the chest maintains balance and
during the 12 move and keep the prevents falling.
head off the bed surface. If
possible, ask the patient to his
knees, bringing his feet close to his
buttocks as possible.

13. Roll the draw sheet of the friction- Rolling the draw sheet reduces friction,
reducing slide sheet and flex your facilitating the patient's upward
knees and hips bringing the forearm movement.
closer to the level of the bed.

14. Inform the client that he will be sheet or the friction-reducing slide
moved up in the bed on the count of sheet
three as nurses will lift the draw
Informing the patient about the
impending move ensures cooperation
and minimizes anxiety.

15. Move in coordination to transfer the Moving in unison reduces the risk of
clients up towards the head of the injury and discomfort during the
bed. transfer.

16. Reassess client's body alignment Ensuring the patient's alignment is

and ensure comfort. maintained promotes comfort and
prevents potential complications.

17. Raise the siderails of the bed. Place Raising the siderails after the transfer
the call bell within clients reach. enhances patient safety and prevents
falls.

LOGROLLING THE CLIENT (TWO PERSON)

18. Perform the necessary procedures Ensuring the patient is prepared

the would prepare the client for the maintains safety and comfort during the
transfer. procedure.

19. Position the client in a supine Starting in a supine position provides a

position. stable base for the lateral movement.

20. Place a draw sheet or fiction- Placing a slide sheet minimizes friction
reducing side sheet under the and supports the patient's movement.
client's back and hips.

22. Pull the client to the side of the bed. Shifting the patient to the side of the bed
readies them for the lateral transfer.

a. Stand with another nurse on the Standing with another nurse on the
same side of the bed. Assume a same side of the bed ensures
broad stance with one foot coordinated movement and effective
forward, roll and grasp the edge communication. Assuming a broad
of the draw sheet or the friction- stance with one foot forward enhances
reducing device.
stability and provides a solid base for
the transfer. This stance allows the
healthcare providers to maintain
balance and control throughout the
movement.
 b. On a signal, pull the client
toward both of you. Both of the Rolling and grasping the edge of the
nurses pull the client to the side draw sheet or friction reducing device
of the bed by shifting their under the client's back and hips is
weight to the back foot. essential to create a smooth surface for
the client to move. This minimizes
friction and reduces the risk of skin
shear during the transfer.

23. One nurse moves to the other side another pillow between the client's
of the bed, and places supportive legs.
devices for the client when turned, Placing pillows supports the patient's
one pillow at the head part and head and prevents pressure ulcers.

24. Cross the client's arm over his Crossing the patient's arm over the
chest. chest ensures balance and stability
during the roll.

25. Roll and position the client in proper Rolling the client in proper alignment is
alignment. essential to prevent musculoskeletal
strain and discomfort for both the client
and healthcare providers.

a. Fanfold or roll the draw at the shoulder part of the client and
sheet/friction-reducing device hips.
alongside of the client. One nurse
goes to the other side of the bed rolling the draw sheet or friction-
away from the rolled draw reducing device alongside the client
sheet/friction-reducing device. The minimizes friction during the logroll.
nurse assumes a stable stance and This reduces the risk of skin shear and
reaching over the client, grasp the maintains the client's comfort.
draw sheet/friction-reducing device

b. The second nurse (behind the

client) helps turn the client and the second nurse positioned behind the
provides pillow supports to ensure client aids in maintaining proper
good alignment in the lateral alignment during the turn.
position.

c. On a signal, both of the nurses roll Smooth movement minimizes

the client as one unit in a smooth, discomfort and potential complications.
continuous motion.
 26. Support the client's head, back, and Using pillows maintains alignment and
upper and lower extremities with comfort post-transfer.
pillows. Ensure proper alignment of
client's body and comfort.

27. Raise the side rails and place the Raising the siderails prevents falls and
call bell within the client's reach. ensures patient safety.

ASSISTING A CLIENT TO SIT ON THE SIDE OF THE BED

29. perform the necessary procedures Ensuring the patient is prepared

the would prepare the client for the guarantees a safe and comfortable
transfer. transfer.
30. Position yourself and the client Proper positioning minimizes strain
appropriately before performing the during the transfer
move.

(a) Assist the client to a lateral position Assisting the client to a lateral position
facing you, using an assistive facing the caregiver ensures that the
device depending on client client is in a safe and comfortable
assistance needs. starting position. The use of an assistive
device is tailored to the client's specific
needs, minimizing strain and discomfort
during the transfer.

(b) Raise the head of the bed slowly to Gradually raising the head of the bed
its highest position. maximizes the client's comfort and
allows for a smoother transition to a
sitting position.

(c) Position the client's feet and lower Proper leg positioning facilitates the
legs at the edge of the bed. sitting movement.

(d) stand beside the client's hips and forward from the hips. Flex your
face the for corner of the bottom of hips, knees, and ankles.
the bed the angle in which
movement will occur). Assume a Proper stance and trunk positioning
broad stance, placing the foot prevent strain during the transfer.
nearest the client and head of the
bed forward. Lean your trunk
 31. .Move the client to a sitting position,
using an assistive device Using patient's stronger arm and
depending on client assistance pivoting ensures controlled movement.
needs.

(a) Place the arm nearest to the head Placing one arm under the client's
of the bed under the client's shoulders and the other arm over the
shoulders and the other arm over thighs near the knees provides stable
both of the client's thighs near the and balanced support.
knees.

(b) Pivot on the balls of your feet in the Pivoting on the balls of the feet while
desired direction facing the foot of facing the foot of the bed facilitates a
the bed while pulling the client's feet controlled and smooth movement.
and legs off the bed.

(c) Keep supporting the client until the Ensuring the patient is balanced
client is well balanced and comfortable. guarantees a safe sitting position.
Place the call bell within client's reach.

TRANSFERRING BETWEEN BED AND CHAIR

32.Perform the necessary procedures the Preparing the patient ensures a smooth
would prepare the client for the transfer. transfer process.

33. Position the equipment appropriately. Properly positioning the equipment

minimizes the risk of accidents during
the transfer.

(a) Lower the bed to its lowest position Lowering the bed and locking its wheels
so that the client's feet will rest flat provides a stable platform for the
on the floor. Lock the wheels of the transfer. Having the client's feet rest flat
bed. on the floor aids in maintaining balance
and stability.

(b) Place the wheelchair/chair parallel

to the bed and as close to the bed Placing the wheelchair or chair close to
as possible, facing the foot of the the bed ensures a smooth transition
bed. Position the wheelchair/chair between surfaces. Positioning it on the
that would allow the client to move client's stronger side enhances their
toward his or her stronger side. If
ability to move towards the chair,
using wheelchair, Lock the wheels
of the wheelchair and raise the reducing the risk of strain or imbalance.
footplate.
34. Assist the client to a sitting position on Assisting the patient to a sitting position
the side of the bed. prepares them for the transfer.

35. Assess the client for orthostatic Assessing for orthostatic hypotension
hypotension before moving the client from prevents dizziness or falls during the
the bed. transfer.

36. Assist the client in putting on a

bathrobe and nonskid slippers or shoes. If Preparing the patient's attire and using a
available, place a gait/transfer belt snugly gait belt ensures safety and stability.
around the client's waist. Check to be
certain that
the belt is securely fastened.

37 Give explicit instructions to the client. Clear instructions guide the patient
Ask or position the client to: during the transfer.

(a) Move forward and sit on the edge of Moving forward allows the client
the bed lor surface on which the to position themselves close to
client is siting) with feet placed flat the edge, reducing the effort
on the floor. required to stand.

(b) Lean forward slightly from the hips. sequence. This action facilitates
the transition from sitting to
Leaning forward from the hips standing and minimizes strain on
shifts the center of gravity and the lower back.
initiates the movement

(c) Place the foot of the stronger leg creates a stable foundation for
beneath the edge of the bed (or pushing up. The other foot
sitting surface and out the other foot positioned forward helps in
forward. achieving a balanced and
coordinated movement.
Placing the stronger leg beneath
the edge of the bed or surface

(d) Place the client's hands on the bed Placing the client's hands on the
surface (or available stable area so bed or available stable area
that the client can push while allows them to push off while
standing. standing up
38. Position yourself correctly: Standing in front of the client provides
you with a clear view of their movements
(a) Stand directly in front of the client and allows direct communication.
and to the side requiring the most Holding the gait/transfer belt with the
support. Hold the gait/transfer belt nearest hand ensures immediate
with the nearest hand; the other
support and control.
hand supports the back of the
client's shoulder.

(b) Assume a broad stance, placing Mirror the placement of the client's feet, if
one foot forward and one back. possible.
Brace the client's feet with your feet
to prevent the client from sliding Bracing the patient's feet prevents
forward or laterally. sliding during the transfer.

39. Assist the client to stand, and then Assisting the patient to stand maintains
move together by pivoting toward the safety and balance.
wheelchair or sitting area to which you wish
to transfer the client.

40.Assist the client to sit in the wheelchair Assisting the client to sit involves
or chair maintaining proper posture of the controlled and smooth movements to
client. prevent sudden jarring actions.
Maintaining proper posture during this
step ensures the client's comfort and
safety.

Monitoring for any signs of distress,

41. Ensure client's safety and comfort. proper seating, and confirming the
client's balance and security in the new
position contribute to their overall well-
being.

TRANSFERRING BETWEEN BED AND STRETCHER (TWO PERSON)

41. Perform the necessary procedures the Preparing the patient ensures a smooth
would prepare the client for the transfer. transition to the stretcher.

42. Adjust the client's bed in preparation for Adjusting the bed ensures a safe
the transfer. Ensure bed wheels are transfer height.
locked.
43. Place a draw sheet or friction-reducing Placing a slide sheet reduces friction
slide sheet under the client's back and during the transfer.
hips.

44. Place the stretcher parallel to the bed Proper stretcher placement facilitates a
next to the client and lock the stretcher seamless transfer. Placing bath
wheels. You may fill the gap that exists blankets between the bed and stretcher
between the bed and the stretcher loosely fills any gaps and provides a smoother
with the bath blankets. surface for the transfer.

45. Transfer the client securely to the Coordinated transfer between

stretcher. healthcare providers ensures patient
safety.

(a) One nurse needs to be at the side Having one nurse at the side of the
of the client's bed, between the client's bed and another nurse at the side
client's shoulder and hip. of the stretcher between the client's
shoulder and hip ensures balanced and
controlled movement during the
transfer.

(b) The second nurse should be at the

side of the stretcher positioned This positioning provides optimal
between the client's shoulder and support for the client's upper body and
hip. maintains alignment.

(c) The nurses must position their feet Placing the nurses' feet in a walking
in walking stance. stance, with one foot forward and one
back, enhances stability and allows
them to generate controlled force during
the transfer.

(d) Cross the client's arms over his Crossing the client's arms over their
chest. Ask the client to flex the neck chest prevents accidental contact with
during the move, if possible. surfaces and equipment during the
transfer. Asking the client to flex their
neck minimizes the risk of discomfort
and strain on the neck muscles.

(e) On a planned command, the nurse client toward the stretcher. (shifting
at the stretcher's side pull (shifting weight to the front foot).
weight to the rear foot), and the
nurse at the bedside pushes the Coordinating the movements of the
nurse at the stretcher's side (pulling)
and the nurse at the bedside (pushing)
ensures a synchronized transfer.

46. Ensure client comfort and safety. Ensuring patient comfort prevents
discomfort during the transfer.

At the end of position changes.

47. Do aftercare. Secure assistive devices, aftercare ensures patient comfort and
if used. safety post-transfer.

48. Perform proper handwashing. Hand hygiene minimizes the risk of

infections.

49.Document all relevant information. to moving and turning (e.g., anxiety,

Record: time and change of position discomfort, dizziness)
moved from and position moved to, any
signs of pressure areas, use of support Documenting relevant information
devices, ability of client in moving and ensures accurate patient records.
bearing weight and response of the client

50.Reports to the nurse-on-duty or Reporting to the nurse-on-duty ensures

attending physician for any pertinent continuity of care.
observation.

OTHERS
51. Maintains body mechanics throughout the performance of the assessment.
52. Receptive to criticisms and observes courtesy.
53. Shows calmness and maintains composure while performing the procedure.
54. Exercises proper and fluent use of English language.
55. Shows mastery of the procedure.