A transfer is the safe movement of a person
from one surface to another.
Planning and organization are required before
a patient attempts a transfer.
All safety precautions associated with the
transfer need to be observed.
Transfers are identified in different ways:
Number of persons performing transfer
1-person, 2-person, 3-person
Description of transfer
Standing, sitting, recumbent, sliding board
Manual or mechanical method
stand pivot, step pivot, NDT, sliding board, Hoyer lift, etc.
Amount of assistance client requires
Transfer or lift, dependent, max/mod/min assist, supervision
Location of transfer
Bed, Gurney, Chair, W/C, Mat, Floor, Car
Verbal Cues, Gestural Cues, Written Cues
Contact Guard Assist, Standby Assist
Dependent or Total assist
The OT/OTA/team collaborate with other disciplines to
determine the transfer goal
The OT/OTA teaches pt./ staff/caregiver to perform lift as
safely as possible
The OT/OTA teaches the pt. to transfer as independently and
as safely as possible.
The OT/OTAs’ primary responsibility during a transfer is to
guard and protect the pt to avoid injury to the pt or the
Transfers occur frequently during OT intervention
Know patients’ sensory, physical, cognitive, and
Be aware of any medical precautions.
Know your own abilities and limitations
Use good body mechanics.
Recognize when and how much mechanical or
human assistance is needed for a safe transfer.
Mechanical devices can keep pts dependent so
recommend only if the pt and/or caregiver can not
perform the transfer safely without them.
Hoyer or other form of hydraulic, or electrical lifts
Dangerous if incorrectly used
BUT - May be only safe method to transfer dependent
MUST know/observe weight limits for specific device
State of TN mandates specific number of
persons to perform lift based on client
1 person = < 50 lbs
2 person = > 50 lbs and < 100 lbs
3 person = >100 lbs and < 150 lbs
Mechanical lift = >150 lbs
Term transfer may be used for both
Transfer - Client performs all, part, or none of
transfer with assistance provided as needed for
safety. No lifting of client occurs.
Lift – Client is dependent for entire movement
and is physically lifted from one surface to
Transfers involve close personal contact.
Many clients are fearful of transfers/potential of
falling/experience pain when held/moved
Introduce yourself, explain what you are going to do in simple
Have the client repeat back to you what you are going to do, or
give non-verbal consent
Tell client before touching their trunk, leg or buttocks.
Stay in contact guard with the client
Use a safety belt, which is also called a gait, guard,
ambulation, or transfer belt.
Always request pt’s permission to use belt if cognizant
Fasten as snugly as possible at or just above patient’s hips
IF belt slides upwards, it is too loose
IF patient is obese, pregnant, or has an abdominal or lower
spine incision, fasten belt just beneath rib cage
Belt remains on until patient is in a safe, stable position
It is possible to safely transfer a client without a safety belt,
however belts are mandated by most facilities/agencies
When giving instructions—
Use simple, action-oriented verbs
Encourage pt. to participate mentally and physically
as much as possible.
If using someone to assist, tell them exactly what
you need/want them to do or not do
OTA - Make sure long hair is tied back, no dangling or
sharp jewelry , name tag will not be in the way, nails are
short, and you are wearing non-skid footwear.
Client - Make sure all tubes (catheter, O2,IV, etc.), leads
(EKG, BP, etc.), and other items (sheets, bandages, etc.) are
properly positioned so as not to become caught or
tangled during transfer, and that non-skid surface is on
or under feet.
Environment - Make sure transfer area is dry, without
trip or fall hazards, moveable surfaces locked.
Hips scooted ½ way towards front of seat
Feet flat on floor
Lean trunk forward (‘nose over toes’) approx 45
Look in direction of transfer
Use 1-2-3 rocking momentum
Use hand(s) to push on stationary surface to
Make sure W/C front caster, armrest, and leg rest are
not in the way
Never allow pt. to grab around your neck during a
Maintain CGA (contact guard assist) throughout the
transfer until you are sure that pt is safe performing an
Do not move away from the pt until they in a safe
Once a transfer is started, be prepared to either
complete it or return pt. to original position
OT/OTA’s role is to safely lower pt. to nearest
surface without injury
Bed/Mat – can push patient backwards onto bed
Chair – may be able to gently lower patient to seat
to prevent fall
Floor – lower pt. gently to floor – OT/OTA must use
good body mechanics, if necessary, cushion pt. with
Wall - If close enough to a wall, may be able to
force a ‘lean’ until balance is regained
Factors that impact independence in transfers:
Cognition – ability to motor plan, sequence, and
Strength of extremities used during transfer
Presence of decreased ROM or pain
Consistency of performance
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