give me multiple chiose quiz questions based on:BED MOBILITY AND
TRANSFER ACTIVITIES
CHAPTER 8 PRINCIPLES & TECHNIQUES
PTA 201 REHABILITATION I
OBJECTIVES
• Discuss how to navigate the patient health record to identify the critical
elements prior to carrying out a sample plan of care
• Provide education to patients, caregivers, health care providers, and
consumers.
• Recognize and monitor activities and position/posture changes that affect vital
signs, edema, dyspnea, pain, sensation, and/or integumentary integrity
• Discuss special precautions and safety considerations required for functional
mobility training.
• Demonstrate competency in common bed mobility techniques.
• Demonstrate competency in stand pivot, squat pivot, and slide board transfer
techniques.
• Recognize levels of functional status in mock scenarios.
• Identify risks and benefits of various types of dependent transfers and
equipment utilized to accomplish these types of transfers.
KEY TERMS
Bariatric: BMI>40
Hemiplegia: paralysis
Paresis: weakness
TRANSFERS
• The safe movement of a person from one surface
or location to another OR from one position to
another
DOCUMENTATION OF TRANSFERS
• Includes level of physical assist the patient
requires:
• Dependent, Max (patient performs 1-49%), Mod (50-
74%), Min (75-99%), CGA, SBA, Supervision, MI, I
• x1 or x2 (assistants)
• Consistency of skill
• Cues provided
• Pt. cooperation, behavior
• Equipment or devices used
BED MOBILITY
• Rolling briding–bed mobility
• Included in transfer activities: supine to sit ,
sit to stand, tansfer bed to wheelchair
• Preliminary to transfers out of bed
• Important for patient comfort
• Important to prevent contracture and skin
breakdown-subluxation
ASSISTIVE DEVICES
FOR BED MOBILITY
Trapeze
Leg lifter
PREP FOR TRANSFER TRAINING
1. Review medical record
• Relevant precautions
Sternal/ Spinal precautions, WB precautions, peg tube feeding
1. Review of PT evaluation including:
• Prior transfer performance (PLOF, previous treatments)
• Transfer goals
• UE/LE strength and flexibility
• Sitting/standing balance
• Sitting/standing tolerance
2. Discuss with nursing and pt.:
I would check with pt’s vitals- comp
• Current status, vitals
• How patient has been transferring with nursing
4. Choose transfer or activity depending
upon:
• Evaluation results
• Information available from records and patient
• Goals of treatment
• Current medical status
While pt. independence is a frequent goal of
transfer training, the PT/PTA’s primary
responsibility during practice of a transfer is
to guard and protect the pt. to avoid injury
TRANSFER PREP
• Follow “preparation” steps as on your competency forms
• Check and secure all equipment and personnel
• Active(safty I didn’t do) vs. Latent Error( safety issue I can’t
control- no AD aviablie)
TRANSFER PREP TIPS
• Lock the bed/ Nonstick socks/ gait belt/ arrange the room-move
stuff out of the way
• Make sure the patient is dressed appropriately (clothes, footwear)
• Demonstrate the transfer first (verbal and visual cues)
• Use simple, step-by-step, action commands
• Have the patient repeat the steps of the transfer back
• Warm-up with a functional exercise – nose over toes. / bend your
knees roll back and forth
PATIENT/CAREGIVER SAFETY IS #1 PRIORITY
• Gait belt
• Proper footwear
• Protect bandages, casts, equipment
(Catheter/bag, IV, drainage tubes, feeding
tubes, dressing/surgical sites, etc.)
• Use optimal body mechanics
SAFETY PRECAUTIONS CONT.
• Secure and/or lock all necessary equipment(wheelchair)
• Clear area of unnecessary equipment and other hazards
• Anticipate the need for an assistant
• Do not leave pt. unattended w/o adequate support, stabilization & protection
• Be aware of any activity precautions –
surgical precautions
TABLE 8-3, P. 173
CONDITIONS REQUIRING SPECIAL
PRECAUTIONS DURING TRANSFERS
Total Hip Arthroplasty (THA)
• Posterior or posterolateral approach
• NO adduction, IR, Flex >90 degrees of the affected hip
• No extension beyond neutral
• Anterior approach: little or no post-surgical precautions
Raised toilet seat
Abd pillow
Sternal Precautions :6-8w
• Typical following cardiac procedures
• NO pushing/pulling/lifting >10lbs
• NO reaching behind your back or overhead
• Arms may be crossed or holding pillow during mobility
• Coughing/ sneezing/laughing with hands on the chest
protect fx
Ask have your nurse reviwed your sternal precaution with you?
Spinal precautions and/or Low back pain
• NO Bending, Lifting, Twisting (BLTs)
• Log roll
• Avoid excessive trunk rotation, sidebending,
flexion
CVA: Hemiplegia
• Do NOT pull on the involved UE or LE that is flaccid -
subluxation
• In sidelying make sure involved scapula is protracted to
avoid lying directly on involved GH joint-do protraction
• Log roll
SCI: Quadriplegia/Paraplegia
• Avoid distractional and rotational forces – do NOT pull
on LE
• Log roll
• Be aware of possible syncope with position change
• Caution for high risk for osteoporotic fracture
• Be aware of protective, supportive external appliances
and/or internal fixation
Burns
• Avoid shearing forces across the burn or graft sites
• Draw sheet
These are only guidelines. ALWAYS
follow hospital protocol and MD (PT)
specified precautions for you patient.
TYPES OF TRANSFERS
• Seated
• Sliding board
• Standing
• Squat pivot (semi-standing)
• Standing pivot
• Recumbent /Dependent
• Pt. can’t sit and can’t assist with the transfer
• Requires 1-3 people to assist and/or special equipment
SLIDING BOARD TRANSFERS
Parallel to the bed
HOYER LIFT TRANSFERS
SIT TO STAND MECHANICAL LIFT
GENERAL PRINCIPLES
• Generally, it is safest to transfer a pt. to his
strong side
• Guard the knee on the weak side to prevent
buckling
• Placing the involved leg out in front may help
manage pain and WB precautions
• Pulling to stand may be easier but is less
functional
ASSISTIVE DEVICES FOR
PIVOT TRANSFERS
TRANSFER VIDEOS!!
https://www.youtube.com/channel/UCTqgeZKTtAF6BG7m5w
MSZng
STEP BY STEP: W/C TO BED
1. Parallel to bed or up to 45 degrees to bed
2. Lock brakes of w/c
3. Gait belt securely on pt.
4. Remove or swing away footrests (may need to
move bed-side footrest before positioning w/c
against bed)
5. Remove bed-side armrest (unless pt. needs it
to push up)
6. Scoot pt’s bottom to front of seat (decrease
shearing by laterally shifting rather than sliding,
if necessary)
7. Properly position pt’s feet
8. Grasp gait belt around pt
9. Facilitate forward weight shift (stand/squat
pivot)
•
“Nose over toes”
•
“Look up”
10. Forward and up
11. Guide, assist as necessary to pivot the full
distance to sit securely on bed