Transferring: Bed to stretcher

• Transferring


  A nursing skill that helps weakened or dependent patients or patients with restricted mobility attain positions to regain optimal independence as quickly as possible
• Patient safety is often the main concern when moving patients from bed
• Never move a patient by yourself. Two people usually can do this move safely
• Gravity


  Causes a person who is sitting in bed to slide down over time, leading to discomfort and interfering with the person's ability to breathe
• Equipment for transferring


  • Hospital bed with side rails
  • Pillows or rolled sheets (Trochanter rolls) or wedges for positioning
  • Draw sheet or turning sheet
  • Towel
  • Transfer belt or gait belt
  • Trapeze
  • Gloves
• Assessing patient before transferring

  1. Assess the patient's physical abilities such as muscle strength

  2. Review the patient's chart for any limitations in physical activity

  3. Assess patient's ROM, alignment, and comfort level while patient is lying down

  4. Assess patient's level of consciousness

  5. Assess condition of patients skin

  6. Assess for presence if external medical device / equipment (e.g., intravenous [IV] line, external fixators or oxygen tubing)

  7. Assess patient's ability to understand instructions

  8. Assess degree of comfort or discomfort when moving

  9. Assess nurse's own strength and ability to move the patient. Seek help from other health workers as necessary
• Preparing for transferring


  1. Remove all pillows and devices used in previous position

  2. Prepare needed materials and assistive devices that may be required

  3. Consider the medications taken by the patient as this may hamper alertness during the procedure
• Identifying the patient and ensuring privacy

  1. Identify the patient, greet by name and explain the procedure to be done

  2. Close door to the room or close the bedside curtains
• Adjusting the bed


  Raise bed on the height at the center of gravity and put bed in flat position
• Handwashing and using standard precautions

  Perform handwashing. Wear gloves and follow standard precaution if contact with blood or body fluids cannot be avoided
• Moving patient to one side of the bed

  Remove the pillow and place it at the head of the bed

  2. Then move the patient to one side of the bed
• Moving a patient up in bed (one person assist)

  After rolling the patient to one side, place a half rolled-up slide sheet or draw sheet against the patients back

  2. Roll the patient onto the sheet and spread the sheet out flat under the patient

  3. Make sure the head, shoulders and hips of the patient are on the sheet

  4. Pull the sheet upwards to be able to pull the patient up. Never move patients by grabbing them under their arms and pulling

  5. If the patient can help you, ask the patient to:

  5.1 Bring the chin up to the chest and bend the knees. The patient's heels should remain on the bed

  5.2 Have the patient push with the heels while the nurse pulls the patient up
• Moving a patient up in bed (two to three person assist)

  Use steps 6.1, 6.2 and 6.3

  2. Both people assisting should grab the slide sheet or draw sheet at the patient's upper back and hips on the side of the bed closest to them

  3. On the count of three, move the patient by shifting the nurse's weight to the front leg and pulling the sheet towards the head of the bed

  4. The nurses may need to do this more than once to get the patient in the right position
• Moving a patient to the side of the bed

  To move his upper body, slide one arm under his head & shoulders, and one arm under his back; then slide his upper body toward you

  2. To move his lower body, slide one arm under his hip's ad one under his thighs, and then slide his lower body toward you
• Turning a patient to his side


  When the nurse is working alone, turn the patient toward you

  2. Stand on the side of the bed toward which the patient is to be turned

  3. Flex his knees toward you

  4. Then go to the opposite side of the bed

  5. Slide your arms under the patient's hips and draw his hips toward you, toward the center of the bed

  6. Flex his upper leg forward on his extended lower leg to prevent him from rolling back

  7. Check his shoulder alignment

  8. His lower arm should be in front of his chest or extended along his back, but not caught under his body

  9. Return to the original side of the bed. Arrange the pillow to support his head

  10. Use two additional pillows to support his upper arm and upper leg, and to maintain shoulder and hip alignment
• Transferring a patient from bed to stretcher

  In preparation to move, put the head of the bed down and adjust the bed height
• If you are using a slide sheet, make sure it is removed when the transferring is done. This is to avoid making the patient feel uncomfortable
• A patient is easier to move or lift when he is close to the side of the bed since the nurse can be closer to the patient's center of gravity
• When working alone move the upper and lower parts of the body separately
• Facing direction of movement prevents twisting of nurse's body while moving the patient
• Provides support across length of a patient's body
• Prevent trauma to a patient's musculoskeletal system by supporting shoulder and hip joints and evenly distributing weight
• Decreases friction and enables patient to use leg muscles during movement
• Reduces friction. Increases patient's mobility. Decreases nurse's workload
• Transferring a patient from bed to stretcher

  1. Put a garbage bag or plastic slide board between the sheet and draw-sheet, beneath one edge of the patient's torso

  2. Move the patient's legs closer to the edge of the bed

  3. Instruct the patient to cross his or her arms across his or her chest and explain the move to the patient

  4. Pull patient to the edge of the bed and then grasp the draw-sheet on both sides of the bed

  5. On the count of 3, lean back and the leader should shift his weight, sliding the patient to the edge of the bed. The helper holds the sheet, keeping it from slipping

  6. In positioning the stretcher, have the helper "cradle" the patient in the draw-sheet while the nurse retrieves a stretcher

  7. Adjust the bed to be slightly higher than the stretcher. Then position the stretcher, locking it in place

  8. Move the patient's legs onto the stretcher

  9. As the patient slide into the stretcher, have the helper kneel on the bed, holding on to the draw-sheet

  10. On the count of 3, grasp the draw-sheet and slide the patient onto the stretcher. You may need to repeat this step, if necessary
• Transferring a patient from bed to wheelchair

  1. Position the bed at the lowest setting

  2. Lock the wheelchair close to the bed

  3. Remove the armrest nearest to the bed and swing away both leg rests

  4. Help the patient turn onto his or her side, facing the wheelchair

  5. Put an arm under the patient's neck with your hand supporting the shoulder blade; put your other hand under the knees

  6. Swing the patient's legs over the edge of the bed, helping the patient sit up. Patients knees should be between your legs

  7. Have the patient scoot to the edge of the bed

  8. Put your arms around the patient's chest and clasp your hands behind his or her back. Or you may also use a transfer belt to provide a firm handhold

  9. Supporting the leg farthest from the wheelchair between your legs, lean back, shift your weight and lift

  10. Keeping your knees bent, have the patient pivot toward the wheelchair, as you continue to clasp your hands around the patient

  11. A helper can support the wheelchair or patient from behind

  12. As the patient bends toward you, bend your knees and lower the patient into the back of the wheelchair

  13. A helper may position the patient's buttocks and support the wheelchair
• Transferring a patient from bed to mechanical lift


  1. Assist patient to side-lying position facing away from you

  2. Position sling or canvass straps underneath patient from shoulder to knees

  3. Raise side rail, move to the other side of bed and lower side rail

  4. Assist patient to side-lying position again facing away from you

  5. Pull sling or canvass straps toward you so they are flat on mattress

  6. Assist patient to supine position, raise side rail, and lower opposite side rail

  7. If using overhead mechanical lift system, position lift mechanism directly over center of patient

  8. Make sure locked wheelchair is next to bed

  9. If using portable lift system, place u-shaped base underneath bed on same side as wheelchair

  10. Lock wheels on lift

  11. Attach straps to swivel bar

  12. Instruct patient to cross arms over chest

  13. Raise head of bed

  14. Secure straps

  15. Use electronic controls to lift patient over wheelchair

  16. When using portable lift, slowly pump lift handle or use controls to lift patient over wheelchair

  17. Slowly lower patient into wheelchair

  18. Remove straps from bar and slide; move lift away from wheelchair

  19. Assist patient to comfortable position with call light within reach

  20. Reverse steps to return patient to bed
• Transferring patients


  • Patient safety is often the main concern
  • Nurse should not lift at the expense of their own back
  • Requires clear communication with patient
  • May need two people if patient can't help much
  • Brace nurse's knees against patient's to prevent buckling
  • Transfer toward patient's stronger side if possible
  • Mechanical lift takes strain out of lifting and reduces injury risk
  • Communicate with patient to keep them calm when using mechanical device
• When a patient is not able to bear weight on his or her feet, a mechanical lift should be used
• A mechanical lift takes the strain out of lifting and drastically reduces the risk of injury