5. You should apply these principles to any
patient handling technique you use, whether
it’s from these guidelines or another source.
No technique is safe if you are handling most
of the patient’s weight.
Note: the term carer means any HCA, nursing
staff, porter or pt. attendant who is assisting
pt. in lifting and transfer.
6. 1. Wear the right clothes: Make sure your clothing
and footwear are appropriate – clothes should
allow free movement and shoes should be non-
slip, supportive and stable.
2. Know your limits: Know your own capabilities
and don’t exceed them – for instance, if you need
training in the technique to be used, tell your
manager.
3. Do one thing at a time: Don’t try to do two
things at once – for instance, don’t try to adjust
the patient’s clothing during the transfer.
7. 4. Prepare for the task: Make sure everything is
ready before you start – for instance, check other
carers are available if needed, equipment is ready
and the handling environment is prepared.
5. Choose a lead carer: The lead carer checks the
patient profile and co-ordinates the move. You
should also try to match the height of carers if
possible to avoid awkward postures.
6. Apply safe principles: Always use safe
biomechanical principles – and use rhythm and
timing to aid the task.
8. Caution – High risk. The patient shouldn’t
hold on to you or your clothing, because it is
difficult for you to disengage and the patient
could pull you off balance. It is unsafe for
carers and patients.
9. Applying safe biomechanical principles and
maintaining the natural curve of your spine to
handling tasks minimize the force on your
joints and discs.
Here’s the safe way to hold your body:
10. 1. Stand in a stable position: Your feet should
be shoulder distance apart, with one leg
slightly forward to help you balance – you may
need to move your feet to maintain a stable
posture.
2. Avoid twisting: Make sure your shoulders
and pelvis stay in line with each other.
3. Bend your knees: Bend your knees slightly,
but maintain your natural spinal curve – avoid
stooping by bending slightly at the hips
(bottom out).
11. 4. Elbows in: Keep your elbows tucked in and
avoid reaching – the further away from the
body the load is, the greater the potential for
harm.
5. Tighten abdominal muscles: Tighten your
abdominal muscles to support your spine.
6. Head up: Keep your head raised, with your
chin tucked in during the movement.
7. Move smoothly: Move smoothly throughout
the technique and avoid fixed holds.
12. 1. Check patient profile: Decide if the task is
still necessary and that the handling plan is
still appropriate. Check it still matches the
clinical pathway and physician’s orders.
2. Seek advice: Talk to your manager or the
patient handling adviser if you need advice on
the techniques and equipment you should be
using.
3. Check equipment: Ensure equipment is
available in good order with all components in
place and ready to use.
13. 4. Prepare handling environment: Position
furniture correctly, check route and access
ways are clear, and check the destination is
available.
5. Explain the task: Explain the task to the
patient and other carers who will be helping.
6. Prepare the patient: Ensure the patient’s
clothes and footwear are appropriate for the
task, and they have any aids they need. Adjust
their clothes, aids and position – for instance,
encourage the patient to lean forward.
14. 7. Give precise instructions: The lead carer directs
the move and gives clear instructions, e.g. “Ready,
steady, stand”. This helps carer/s and patient work
together.
NOTE: A clear command of “Ready, steady, stand”
is better than counting “1, 2, 3 go”. If you use
numbers some carers may start on the count 3,
and others on the word go. Numbers also have
less functional meaning to the patient. So giving
a clear command helps co-ordinate everyone in
their moves and makes the task safer.
15. 1. Correct your posture: Stand up straight to
correct your spinal alignment. Hold your chest
open, shoulders back and abdominal muscles in so
your lower body aligns properly with your upper
body.
2. Re-evaluate the task: Could the task have been
done better? How? Mark the patient profile with
your comments.
3. Report any issues: If you identify issues that
affect patient handling, report them to your
manager and add them to the workplace control
plan for action.
16. There are several techniques used in lifting
and transferring of patients.
17.
18. Before helping the patient stand, check there is
enough space around the chair for carers to help.
Steps:
1. Ask the patient to put their hands on the armrests of
the chair, or the firm surface of the furniture on which
they are sitting.
2. Ask the patient to put their feet flat on the floor –
the feet should be apart and tucked back under the
chair.
3. Ask the patient to lean forward in the chair and
shuffle their bottom to the edge of the seat.
4. Ask the patient to lean forward while still sitting so
their upper body is above and over the top of their feet
– ‘nose over toes’.
19. 6. Stand to the side of the chair and face the same way as the
patient (in the direction of the transfer).
7. Bend their knees and hips slightly (bottom out) – feet should
be shoulder distance apart, with the outside leg forward in the
direction of the transfer.
8. Put their outside palm on the front of the patient’s inside
shoulder to help right the trunk and stabilise the patient.
9. Put their inside palm at the base of the patient’s spine to
help the patient bring their upper body over their feet to get
ready for the move.
10. Stay as close as they can to the patient throughout the
transfer, so the patient’s centre of gravity stays as close as
possible to their own centre of gravity.
20.
21. 11. The patient pushes themselves up to a
standing position using the armrests or surface
on which they were sitting while you are
assisting.
Note: The lead carer should say “Ready,
steady, stand”, then lead and coach the
patient through the transfer.
22. Steps:
1. Check the patient can feel the edge of the seat or bed on the
backs of their legs or knees.
2. If the patient is sitting on a bed before lying down, ensure
they sit near the head of the bed so they don’t have to be
repositioned after they lie down.
3. Stand to the side and if possible behind the standing patient.
4. Put their outside palm on the front of the patient’s shoulder.
5. Put their inside palm on the patient’s outside hip or lower
back
23.
24. 6. Ask the patient to reach behind and take hold of
the armrests or feel for the firm surface of the
furniture on which they are about to sit.
7. Ask the patient to lean forward (‘nose over toes’)
and, at the same time, bend at the knees and hips to
lower themselves onto the furniture while you are
assisting.
8. The lead carer should say “Ready, steady, sit”,
then lead and coach the patient through the transfer.
25.
26. Steps:
1. Adjust the bed to the correct working height.
2. Stand on the side of the bed towards which the patient will
roll.
3. Turn the patient’s head in the direction of the roll.
4. Position the patient’s inside arm out from the side of their
body, or lift it above their shoulder and rest it on the pillow, or
put it across their chest to stop them rolling onto it.
5. Help the patient flex their outside knee (or both knees) so
they’re ready to push off with their foot in the direction of the
roll.
27. 6. Position the patient’s outside arm across their chest ready for
the roll.
7. If the bed is not height adjustable, place your knee on the
bed so you can perform this technique safely – this helps
prevent you from using an extended reach or bending too far
forward.
8. Place one open palm behind the patient’s shoulder blade and
the other on their hip.
9. Clearly give the command “Ready, steady, roll” so the patient
can hear and assist if possible.
10. If you have your knee on the bed, transfer your weight
backwards and remove your knee from the bed in one co-
ordinated movement on the command “roll”
11. Roll the patient towards you.
28.
29. Do you need extra help?
If you decide the patient should be pushed from behind
to roll, you’ll need help from another carer.
1. Get the patient ready (steps 1-8).
2. The second carer places their open palms behind the
patient’s top shoulder and hip.
3. The first carer rolls the patient towards them, while the
second carer pushes the patient in the direction of the
roll.
4. If the bed is not height adjustable both carers have one
knee on the bed and the other on the floor – you both
remove your knees on the “roll” command.
30. Technique 1 is for those patients who are
relatively active or having one side paralyzed
due to brain tumor or CVA (stroke).
31.
32.
33.
34.
35. Points to remember before WHEEL CHAIR
transfer.
1. Do not position the wheelchair too far
from the exam table or the receiving surface.
2. Do not position the wheelchair so that the
patient faces the side or the foot of the exam
table or receiving surface.
This increases the steps and turns the patient
has to take.
36. 3. Place the wheelchair at a 45° angle to the
bed so the patient will be transferring to his
stronger side.
4. Lock the wheel chair
5. Flip up the footplate
6. Turn the footrest to side
7. Place the feet on footplate when patient on
wheel chair.
8. Do not allow or ask patient to wrap their
arms around your neck because this could
injure your neck.
37. 9. Tell patient every time what you are going
to do.
10. If you found difficulty in grasping patient
do use of gait belt for better handling the
patient.
You can make a “gait belt” out of a sheet by
twisting it and wrap it around the patient.
This will create a “handle” on the patient.
38. Note: if the patient is lying on bed first make
pt. sit at edge of bed as shown below.
1. Bring patient to a sitting position with
his/her legs over the edge of the bed by
following steps a, b, c, and d.
40. 2. Let patient rest a moment if he/she feels
dizzy.
3. Put patient shoes on if he/she can’t.
4. Try to adjust the height of the two surfaces
as even as possible.
5. Conduct the transfer towards patient’s
stronger side.
41. 6. Ask patient to scoot to the edge of the
bed/wheelchair by pushing armrests of the
chair, or the firm surface of the bed on which
they are sitting.
7. Put your arms around patient’s chest and
hold your hands together behind his back.
8. Support patient’s legs between your legs
to avoid knee buckling.
42.
43. 6. Lean back, shift your leg and lift.
7. Pivot your body towards the chair
44. 8. Bend your knees and let him bend toward
you.
9. Lower the patient into the wheelchair
10. Adjust patient position so that he/she is
seated comfortably.
45. Reverse the whole process when shifting pt.
from wheel chair to bed.
46. This technique is for patients with lower limb
paralysis due to cord compression or any
other cause.
47.
48.
49.
50. 1. Open the passenger door as far out as
possible.
2. Move the side of the wheelchair as close to
the car seat as possible
3. Position yourself so that you are facing the
patient.
4. Bend your knees and hips and lower yourself
to his/her level.
51. 5. Hold on to the waist level/transfer belt
around his waist to help patient stand as you
straighten your hips and knees.
6. If patient’s legs are weak, brace his/her
knees with your knees.
52. 7. While patient is standing, turn him/her so
that patient can slowly sit down on the car
seat. Make sure that he/she does not hit
his/her head.
53. 8. Lift patient’s legs into the car by placing
your hands under his/her knees.
9. Move patient to face the front.
10. Put on his/her seat belt.
11. Close the door carefully.
60. Use your thigh and leg muscles, not your
back, as you lift in one smooth movement.
61. Have feet shoulder width apart, with the load
between them.
Get a firm grip on the load.
62. Keep your arms and elbows close to your
side.
Bend your knees and hips keeping your back
straight.
63. Keep a good grip on the load.
Keep loads at a reasonable height so you can
see where you are going.
64. Pivot with your feet – don’t twist your back
when carrying loads.
65. When lowering a load onto a deep shelf, put it
on the edge of the shelf and push it into
place.
66. Push rather than pull.
–– If a person pulls while facing in the
direction of travel, the arm is stretched behind
the body, placing the shoulder and back in a
mechanically awkward posture, increasing the
likelihood of injury.
–– Research demonstrates that people can
usually exert higher push forces than pull
forces.
68. When a load is too heavy and help is not
available, use mechanical equipment.
Lift trucks, push carts, hoists, conveyors, and
trolleys are made for this purpose.
69. The following lifting techniques may be
required in circumstances that make lifting
awkward.
70. Both persons should be about the same
height.
One person takes charge of the lift, so that
you are working together not against each
other.
Lift together, walk in step and lower the load
together.
71.
72. Use the golfer’s lift to pick up light, small
loads when you can’t bend your knees or get
close to the object.
Swing one leg straight out behind you.
Keep your back straight while your body
leans forward.
To help support your body, place one hand
on your knee or on a nearby solid object.
73.
74. Use extra care to avoid twisting the spine.
If your arm span is less than that of the load,
GET HELP.
Adjust your hands to get the best hold
possible.
Use your whole hand not just the fingers
(power grip).
Use the leg and thigh muscles, not your back
to lift the load.
75. Lift the sheet onto a platform to get a better
grip for carrying.
Lower the sheet using lifting techniques in
reverse.
76. Straddle one end of the load, grasping it with
both hands.
Stand up, raising the load to an upright
position.
Stand close to the load and lower your body
to a comfortable level.
Lean the load against your shoulder.
Straighten up and set it upright on a
platform.
Bend the knees until your shoulder is level
with the centre of gravity of the load.
77. Lift using your thigh and leg muscles.
Long loads can be dragged, or rolled on
edge, after being placed in an upright
position.
78. Extra care is required as long loads are
difficult to control.
One lifter takes charge of the lift.
Both lifters start at the heavier end of the
load.
Bring one end of the load up to shoulder
height.
One lifter takes the weight on his/her
shoulder, while the second goes to the
opposite end and lifts it onto a platform and
then onto his/her shoulder
79.
80. Stand at one end of the sack.
Lift it to an upright position.
Straddle the load. Place one hand under the
bottom of the sack and use the other to hold the
sack against your body.
Bend the knees and lift the sack onto a platform.
Stand as close to the lifting platform as possible.
Bend the knees until the load can be balanced
onto your shoulder.
81. Straighten up in one smooth movement.
If the sack is small, place it in a box with
handles and carry.
82. Place your back against the elevated sack,
feet comfortably apart, one in front of the
other.
Hold the sack at the top, making sure that it
doesn’t slip through your hands.
Place your shoulder against the sack, tilting it
forward while taking the weight.
With one smooth movement, straighten your
knees and move forward.
83.
84. Standing on each side of the upright sack:
One person takes charge.
Grasp the bottom corner with one hand, and
the upper corner with the other.
Get a good grip.
Lift together.
Use your legs and thigh muscles, not your
back.
85.
86. Raise the drum to an upright position using
the principles of lifting.
Extra care is needed when the drum is almost
upright, due to shifting of the contents.
Grasp the top rim of the drum, use the
bottom rim to maneuver it into a balanced
position or onto a mechanical device.
87.
88. Wear appropriate clothing and safe,
comfortable shoes:
Wear clothes that are comfortable around
your hips, knees and shoulders.
Avoid wearing clothes with exposed buttons
or loose flaps.
Shoes should be sensible, non-slip with
broad based low heels.
Wear safety shoes where a potential for foot
injury exists.
