Fundamentals Lecture 6: Transfers for Exam II in Engineering

_____ is when a patient performs all aspects of the transfer, including preparation, in a safe manner without transfer device or assistance

Independent

_____ ____ is when a patient performs the transfer independently with transfer devices

Modified independent

_____ is when the patient actively participates, yet requires assistance

Assisted

_____ is when the patient does not actively participate or participates only minimally, and others perform all aspects of the transfer

Dependent

____ is when the therapist is near the patient and is able to provide verbal or physical assistance as appropriate (need for physical assistance is unlikely)

Supervision

_____ _____ is when the therapist is positioned close to the patient, with hands on the patient/gait belt (likelihood of physical assistance being required is mod to high)

Contact guarding

______ assistance is when the patient is able to perform 75% or more of an activity

Minimal

_____ assistance is when the patient is able to perform 25-74% of an activity

Moderate

_____ assistance is when the patient is able to perform 0-24% of an activity

Maximal

The goal of ____ is to assist the patient to become independent or modified independent during transfer activities

Transfers

When in doubt about the amount of assistance necessary for a patient to perform a transfer, obtain _____ ____

Additional assistance

The number of people needed to assist with a patient transfer should be noted in _____

Documentation

_____ includes verbal cueing, monitoring of the environment, and physical assistance

Assistance

Use ____ of the transfer for patient and caregiver understanding

Demonstration

Break up the ____ of the transfer for patient ease of learning

Steps

______ patients, caregivers, and others assisting with the patient transfer on safe environment preparation prior to performing a transfer

Educate

Consider skills that are _____ among transfer activities for ease of learning (generalizability)

Similar

Consider the _____ of the learning environment or the environment in which the transfer occurs

Context (start teaching in a closed environment and progress to an open environment)

Practice using different types of _____

Equipment (varying chair heights, hard/soft seats, with/without armrests)

Encourage ____ ____ to assist learning

Mental practice

Types of _____:

- sliding

- hydraulic lift

- two person lift

- standing pivot

- sliding board

Transfer

A transfer is not complete until:

- patient is ____ in the new position

Secure

A transfer is not complete until:

- ___ ____ are removed

Manual contacts (gait belt, therapist hands)

A transfer is not complete until:

- appropriate _____ & _____ is completed

Positioning & draping

A transfer is not complete until:

- necessary _____ is placed within the patients usable reach

Equipment

A transfer is not complete until:

- patient confirms ____ in new position

Comfort

Patients should always be informed about the transfer by the therapist _____ to initiating the transfer

Prior (include information on the patients role and actions to be performed)

Use _____ ____ during instruction to promote patient understanding

Layman's terms

If more than one person is participating in the transfer a ____ ___ must be designated and should assign roles to other participants

Lead therapist

Use counts or verbal cues to _____ transfer activities

Synchronize

Preparing the _____:

- consider the direction in which the patient will be moving during the transfer

- ensure movement will not be impeded by furniture or other equipment

- equipment that is needed should be within easy reach so you do not compromise patient safety

- avoid wearing jewelry that can become entangled with or scratch your patient

Environment

A ____ ____ is also referred to as a transfer belt or safety belt

Gait belt

A ____ ____ is a secure point of contact and control for whom ever is assisting a patient during a transfer

Gait belt

Improper use of a gait belt reduces safety for both ____ & ____

Patient & therapist

Inappropriate use of a gait belt to pull a patient to standing leads to lack of patient upper body control and excessive lumbar trunk ____

Extension

A ____ transfer is used to transfer a patient between 2 treatment tables, a treatment table and a stretcher, or a stretcher and a bed

Sliding

______ transfer:

- dependent transfer (3 people are needed)

- position stretcher parallel to and against the treatment table

- use a draw sheet to move the patient from original surface to new surface

- if patient cannot control extremity movement, wrap sheet around patient

- lead therapist should lead count or verbal cues to synchronize the transfer between all participants

Sliding

____ _____ transfer is used for dependent patient transfer

Hydraulic lift

_____ _____ transfer:

- only one person is required

- base of lift can be adjusted to fit around equipment

- position sling so seams are on the outside, away from the patient, to avoid pressure areas

- attach chain hooks from the inside of the sling to the outside to reduce likelihood of patient being injured by the hooks

Hydraulic lift

____ ___ ____ transfer is a dependent transfer requiring maximal assistance of 2 persons that is used to transfer a patient from two surfaces varying in height

Two person lift

____ ____ ____ transfer:

- patient must be able to maintain an UE position of shoulder girdle depression, shoulder extension, adduction, IR, and elbow flexion at approximately 90 degrees for successful transfer

- lead therapist should lead count or verbal cues to synchronize the transfer between all participants

Two person lift

____ ____ transfer is an assisted or independent transfer requiring mod to min assistance of one person that is used when a patient can sit, stand, pivot, and bear full weight on at least one LE (have some weakness, pareses, paralysis, or loss of balance or sensation which necessitates assistance to transfer safety)

Standing pivot

____ ____ transfer:

- patient must be able to bear some weight through their LEs

- block LEs during transfer for control to maintain extend LE during transfer

- generally, when a patient has more involvement on one side than the other (transferring toward the stronger side is easier)

- never permit your patent to place their hands around your neck (do not let patient "pull" on you)

Standing pivot

____ ____ transfer is an assisted or independent transfer that is used when the patient has enough strength to lift most of the weight of her/his butt and sufficient sitting balance to move in a sitting position, but are unable to perform a push up transfer

Sliding board

_____ ____ transfer:

- performed using a series of mini "push ups" and sliding sideways along a sliding board from original surface to new surface

- patients should be able to place their palms flat on the sliding board, grasp the armrest or drive wheel of the wheelchair, or make a fist and place the outside of the fist on the sliding board to achieve push ups

- surfaces must be nearly level for this transfer to be successful

Sliding board

____ ____ ___:

- no weight at all

Non weight bearing (NWB)

____ ____ ____:

- percentage or poundage stated by physician

Partial weight bearing (PWB)

___ ____ ____ ___/____ ___ ____:

- may only put their toe down for balance, no weight should be pressed through the limb

Toe touch weight bearing/touchdown weight bearing

____ ___ ____ ____:

- the patient may put as much weight as they can tolerate the limb

Weight bear to tolerance

____ ____ ____:

- no limitation at all

Full weight bearing