Transfer Training

What should you review before performing a transfer?

• Medical record

• Vitals

• Strength

• ROM

• Cognition

• Precautions (WB status)

• Current abilities

Name things you must do to prepare the environment before a transfer.

• Clear the area

• Gather equipment

• Prepare staff if needed

• Ensure anti-slip footwear

• Address draping

• Plan ahead for lines & tubes

• GOOD BODY MECHANICS

• Explain procedure to patient and team

• Secure patient at new location

When should you use a gait belt?

• Always unless contraindicated

• Ex: chest wound, open wound, back injury

What is “No Man’s Land” in transfer training?

• The unsafe space between transfer surfaces

• Minimize it!

Which exam findings affect transfer ability?

• Strength

• ROM

• Balance

• Tone

• Cognition

• Coordination

• Communication

• Vitals

• Home environment

Why is vision and social support important in transfers?

They impact spatial awareness, safety, and likelihood of success with caregiver help

What does NWB mean, and what transfer might be best?

• Non-weight bearing

• No weight through limb; foot cannot touch ground

• Transfer: sliding board, dependent pivot, lift

What does TTWB mean, and what transfer might be best?

• Toe touch weight bearing

• Foot can touch for balance only, NO WEIGHT

• Transfer: sliding board, squat pivot, walker with assitance

What does WBAT mean, and what transfer might be best?

• Weight bearing as tolerated

• Gauge by patient’s pain; as much pain as patient can tolerate

• Transfer: stand pivot, walker transfer, squat pivot

What does PWB mean, and what transfer might be best?

• Partial weight bearing

• Percent of patient’s body weight (50% if not specified)

• Transfer: squat pivot, stand pivot close guarding, walker with assistance

What does FWB mean, and what transfer might be best?

• Full weight bearing

• No limitations, normal weight use

• Transfer: (any) stand pivot, walker, even independent transfers

What is Modified Independent (Mod I)?

Patient is independent but uses assistive device or takes extra time

What is Independent?

Does not require assistance of another person (verbally or physically) to perform transfer safely

What is Standby Assist (SBA)?

Within arm’s length of the patient (close guarding)

What is supervision?

Across the room

What is Contact Guard Assist (CGA)?

PT touches patient for safety but gives no physical assistance unless needed

What is Minimal Assistance (Min Assist)?

• Patient does over 75% of activity

• PT assists less than 25%

What is Moderate Assistance (Mod Assist)?

• Patient does 50-75% of activity

• PT assists for 25-50%

What is Maximal Assistance (Max Assist)?

• Patient does 25-50% of activity

• PT assists for 50-75%

What is Dependent or Total Assistance?

• Patient does less than 25% activity

• PT & staff/devices assist over 75%

What is the primary requirement for a Stand Pivot Transfer?

Patient must be able to bear weight through at least 1 LE and stand with or without minimal assistance

When should a Stand Pivot Transfer be used?

For patients with fair-to-good strength, balance, and WB status of PWB, WBAT, or FWB

What are the key steps of a Stand Pivot transfer?

• Use gait belt

• Block knees

• Cue weight shift

• Assist with pivot

• Ensure safe seated landing

What is the main benefit of a Squat/Tuck Pivot Transfer over a full Stand Pivot?

• Faster

• More efficient

• Patient stays in a tucked, partially standing position

When is a Squat/Tuck Pivot transfer ideal?

For patients with hemiplegia, NWB, or TTWB on one LE, or those who can’t achieve full standing

What is the purpose of a sliding board transfer?

To allow seated transfers for patients who cannot bear weight on LEs or need very controlled motion

What are the key tips for Sliding Board transfers?

• Keep fingers flat on board to avoid pinching

• Block knees

• Lean patient forward

When is a Sliding Board transfer appropriate?

For patients who are NWB or TTWB, have a good UE strength, and need maximum control.

What is the goal of a Walker Transfer?

To allow the patient to stand and pivot using a walker as the front support

When should a Walker Transfer be used?

For patients with good UE strength/balance, and at least PWB status on one or both legs

What is a safety consideration with Walker Transfers?

• Guard closely for knee buckling

• Especially in patients needed mod/max assist

• Consider stand pivot if unsure

When is a transfer considered complete?

When the patient is safely positioned

Name 3 safety reminders for every transfer

• Use a gait belt

• Clear the area

• Communicate clearly with the patient and team

What is a major safety tip when using a trapeze?

• Move it out of the way!

• NOT FOR TRANSFERS

What is Safe Patient Handling?

An approach using equipment to reduce caregiver injuries

Why is SPH important for PTs?

Reduces musculoskeletal injury risks from lifting & transferring patients

What are examples of SPH equipment?

• Mechanical lifts

• Draw sheets

• Full-body transfer board

• Inflatables