CNA: Chapter 17: Safely Moving and Transferring the Person

• transferring person to.from toilet

  make sure toilet seat is raised, so toilet seat and wheelchair are at same level
• Before using mechanical lift: (5)

  -must be trained to use it

  -it must work

  -sling, straps, hooks, chains in good repair

  -person's weight doesn't exceed lift capacity

  -at least 2 staff needed
• Bariatric sling


  for use w/ bariatric lift
• Amputee sling


  for person w/ both legs amputated
• Toiletig sling


  sling bottom is open

  -each person has their own
• Bathing sling


  to transfer person directly from bed/chair into bathtub.

  -left in place and attached to lift during bath
• Extended length sling


  for persons w/ extra large thighs
• Standard full sling


  for normal transfers
• Sling


  for mechanical lift.

  -depends on person's size,, condition, needs, etc.

  -padded, unpadded, or mesh
• Mechanical Lifts


  -for ppl who can't help themselves or are too heavy for staff

  -manual, battery-operated, electric lifts, ceiling-mounted
• A stand and pivot transfer is used if: (3)

  -person's legs strong enough to bear some/all of their weight

  -person is cooperative/can follow directions

  -person can assist w/ transfer
• help person out of bed on their ____ side

  strong
• Transfer (gait) belts used to: (2)


  -support patients during transfers

  -re-position persons in chairs/wheelchairs

  
  

  ----check for snugness by sliding flat hand underneath
• Dangling not used for ppl w/.......

  -Level 4: Total dependence

  -Level 3: Extensive Assistance
• Dangling


  patient sits on side of bed

  -person coughs, deep breathes, and circles legs for circulation, range of motion exercises

  -sit for 1-5 min

  -can get dizzy/faint if get out of bed too fast

  -2 staff may be needed
• Logrolling used to turn: (4)


  -older ppl w/ arthritic spines/knees

  -ppl recovering from hip fractures

  -ppl w/ spinal cord injuries

  -ppl recovering from spinal cord surgery
• w/ at least 1 coworker, use mechanical lift or assist device for:

  -older ppl

  -ppl w/ arthritis

  -ppl recovering from spinal cord injuries/surgeries
• Moving person up in bed alone only if person:

  -small in size

  -follows directions

  -assists w/ much moving

  -uses trapeze

  -can push against mattress with feet

  -nurse says its safe

  -you are comfortable

  
  

  ---best done w/ 2 ppl

  ---use assist device from care plan
• For heavy, weak, and older persons, _____ staff members needed

  2 or more
• # staff for person weighing >200 pounds

  -friction-reducing device

  -at least 3 staff
• # staff for person weighing <200 pounds

  -friction-reducing device

  -2-3 staff
• # staff for Level 3 Extensive Assistance

  -mechanical list or friction-reducing device

  -at least 2 staff
• # staff for Level 4 Total Dependence

  -mechanical list or friction-reducing device

  -at least 2 staff
• To reduce friction/shearing when moving person in bed...

  -roll person

  -use friction-reducing devices (ex. lift sheet, cotton drawsheet, turning pads. large waterproof pad, slide sheets, turning sheet, etc.)
• Friction and shearing can cause...

  infection and pressure ulcers
• Level 4


  (Total Dependence)

  -person can't help w/ transfer. staff perform procedure

  -transferred w/ full-sling mechanical lift
• Level 3

  (Extensive Assistance)

  -person can bear some weight, can sit up w/ help, and maybe can pivot transfer

  -lifted w/ mechanical lift
• Level 2


  (Limited Assistance)

  -person highly involved in moving/transfer procedure. some help needed moving legs. can stand (bear weight), has upper body strength, can sit up

  -can pivot transfer

  -stand-assist or sliding boards useful
• Level 1


  (Supervision)

  -staff need to look after, encourage, or remind person what to do
• Level 0


  (Independent)

  -person walks w/out help. sometimes needs limited assistance
• Levels of dependence

  Level 0: Independent

  Level 1: Supervision

  Level 2: Limited Assistance

  Level 3: Extensive Assistance

  Level 4 Total Dependence
• To safely transfer person, nurse/health team determine: (4)

  -person's dependence level

  -amount of help needed and # of staff needed

  -what procedure to use

  -equipment needed
• transfer


  how a person moves to a from surfaces - bed, chair, wheelchair, toilet, or standing position
• Shearing


  when skin sticks to a surface while muscles slide in the direction the body is moving
• logrolling


  turning the person as a unit, in alignment, with 1 motion

  -spine kept straight

  -2-3 staff needed
• Friction


  the rubbing of 1 surface against another
• B


  When moving a person who weighs more than 200 pounds to a stretcher, OSHA recommends

  A. Use a lateral sliding aid and 2 staff members

  B. Use a lateral sliding aid and 3 staff members

  C. Use a lateral sliding aid or a friction- reducing device and 2 staff members

  D. Use a drawsheet, turning pad, or a large incontinence underpad
• B


  A sliding board may be used to transfer a person from a wheelchair to a toilet if

  A. The person can stand and pivot

  B. There is enough room to position the wheelchair next to the toilet

  C. The staff member does not want to use a transfer belt

  D. The person has lower body strength
• A


  When transferring a person from a wheelchair to the toilet

  A. The toilet should have a raised seat

  B. The toilet seat should be removed

  C. Always position the wheelchair next to the toilet

  D. Unlock the wheelchair to allow movement during the transfer
• C


  As a person is lifted in the sling of the mechanical lift, the person

  A. May hold the swivel bar

  B. May hold the straps or chains

  C. Crosses the arms across the chest

  D. Should keep the legs outstretched