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Workbook 15 Transfers

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NHS Training for<br />

Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong><br />

<strong>Transfers</strong>


Contents<br />

<strong>Workbook</strong> <strong>15</strong> <strong>Transfers</strong> 1<br />

<strong>15</strong>.1 Aim 3<br />

<strong>15</strong>.2 Learning outcomes 3<br />

<strong>15</strong>.3 Lying–sitting transfer 4<br />

<strong>15</strong>.4 Teaching a patient to move up and down the bed 7<br />

<strong>15</strong>.5 Wheelchairs 8<br />

<strong>15</strong>.6 Teaching patients to transfer safely in and out of a bed or chair 9<br />

<strong>15</strong>.7 Teaching a patient to manoeuvre a wheelchair 11<br />

<strong>15</strong>.8 <strong>Transfers</strong> workbook completion 12<br />

<strong>15</strong>.9 <strong>Transfers</strong> reflection 13<br />

© NHS Education for Scotland 2012. You can copy or reproduce the information in this<br />

document for use within NHSScotland and for non-commercial educational purposes.<br />

Use of this document for commercial purposes is permitted only with the written<br />

permission of NES.


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

<strong>Workbook</strong> <strong>15</strong><br />

<strong>Transfers</strong><br />

<strong>15</strong>.1 Aim<br />

The aim of this workbook is to provide the Healthcare Support Worker (HCSW)<br />

with the knowledge and skills required to help patients transfer.<br />

<strong>15</strong>.2 Learning outcomes<br />

By the end of this workbook you will be able to:<br />

■■<br />

■■<br />

■■<br />

Describe, demonstrate and teach the normal sequencing of movement to assist or<br />

facilitate bed mobility with patients.<br />

Assist in teaching patients to transfer safely in and out of a wheelchair using<br />

appropriate aids and from different surfaces and be able to dismantle and<br />

reconstruct a wheelchair for transportation.<br />

Manoeuvre a chair and carry out prescribed practice of manoeuvres with a patient.<br />

<strong>Workbook</strong> <strong>15</strong> Page 3


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

<strong>15</strong>.3 Lying–sitting transfer<br />

As therapists, one of the most important parts of our role is to promote physical<br />

independence.<br />

As a support worker, you may be involved in practicing everyday tasks with a patient to<br />

enable them to be independent again.<br />

A simple but important task is the ability to move around the bed and get in and out.<br />

There are aids to assist with this if required, but our concern here is to assist a patient to get<br />

up from lying by re-educating a normal sequence of movement.<br />

You would only do these activities with a patient who has been assessed as capable by<br />

the therapist. You must not attempt this with a patient who cannot participate.<br />

Activity<br />

With your supervising therapist, have a look at how you would sit up to sit from lying on<br />

your back. Watch a couple of colleagues do the movement.<br />

Describe what they do<br />

You may notice that the person turns their head to the side, then rolls over bringing the rest<br />

of their body with them, whilst pushing up onto the elbow, sitting up and swinging the legs<br />

over the side of the bed.<br />

There will be variations – some will do it differently, but the components above<br />

are common.<br />

<strong>Workbook</strong> <strong>15</strong> Page 4


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

Activity<br />

Watch your supervising therapist teach a patient how to get out of bed to sit on the side<br />

in this way.<br />

Once you are ready, your supervisor will watch and correct as you teach a patient to get<br />

up from lying in this way.<br />

Describe the instructions you gave to the patient<br />

You may tell them to:<br />

■■<br />

turn their head and reach over the side of the bed to turn onto their side<br />

■■<br />

now to lift their head up and push onto their elbow<br />

■■<br />

now swing their legs over the side and come up to sit<br />

The patient may get stuck at any one of these stages; therefore you should know where to<br />

place your hands to assist.<br />

You may also need someone on the bed behind the patient when they get to sitting, to<br />

ensure that the patient does not fall backwards.<br />

You must ensure that:<br />

your own position is safe<br />

that you are working within your base of support<br />

your spine is in a line<br />

the bed is at the right height to ensure that you are not flexing too much<br />

■■<br />

■■<br />

■■<br />

■■<br />

You may wish to assist the patient by placing your hands at the shoulder girdle and pelvis to<br />

assist them to roll over.<br />

<strong>Workbook</strong> <strong>15</strong> Page 5


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

Activity<br />

Practice this with a model, try assisting them to roll over.<br />

You will notice that by placing your hands on their pelvis and shoulder, you can bring<br />

them on to their side more easily.<br />

You may need to assist to bring the legs over the side also.<br />

From your manual handling training, what handling aids might you use to assist a<br />

patient to come out of bed independently?<br />

■■<br />

A fabric turntable or a slide sheet under the patient’s hips may assist them to sit round<br />

over the side.<br />

■■<br />

A slide sheet under the legs may assist the patient to bring them over the side of the bed.<br />

Evidence<br />

Provide an example of having practiced lying to sitting or sitting to lying with a patient in<br />

the gym or on the ward.<br />

Describe what you told the patient to do and what aids you used and why<br />

What went well, what went not so well, what would you do differently next time?<br />

<strong>Workbook</strong> <strong>15</strong> Page 6


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

<strong>15</strong>.4 Teaching a patient to move up and down the bed<br />

One difficult movement for patients can be moving up the bed in a seated position. You<br />

may be required to assist the patient to do this prior to carrying out some therapy.<br />

Again this can be done with one or two members of staff depending on the outcome of your<br />

risk assessment. Remember to speak to the patient and the nurse caring for the patient, and<br />

to observe the patient carefully before making a decision about how to move the patient.<br />

It is important for the rehabilitation of the patient to encourage him or her to be as<br />

independent as possible.<br />

If the patient can come to a sitting position independently, encourage him to do so. If not,<br />

you may have to use your body weight or a towel behind the patient’s back, to assist the<br />

patient to come to sitting.<br />

To move the seated patient up or down the bed, it may be necessary to:<br />

■■<br />

■■<br />

■■<br />

instruct the patient in use of handling blocks<br />

assist with the patient placing his hands on the bed either side of his body, his knees bent<br />

and feet flat on the bed, hold the patient’s feet to provide him with purchase as he moves<br />

himself up the bed by straightening his knees<br />

use a slide sheet under the patient’s buttocks to assist the manoeuvre with the assistance<br />

of two staff.<br />

Evidence<br />

With your supervising therapist, conduct a risk assessment and assist a suitable<br />

patient to move up or down the bed.<br />

■■<br />

■■<br />

■■<br />

■■<br />

■■<br />

■■<br />

Assess the risk in moving individual patients in bed.<br />

Assist the patient to sitting with one.<br />

Assist the patient to sitting with two.<br />

Assist the patient to move up or down the bed independently.<br />

Assist the patient to move up or down the bed with one.<br />

Assist the patient to move up or down the bed with two.<br />

■■<br />

Use appropriate handling aids safely.<br />

<strong>Workbook</strong> <strong>15</strong> Page 7


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

<strong>15</strong>.5 Wheelchairs<br />

Backrest; folds down backwards and collapses inwards.<br />

Armrest; these are removed by<br />

releasing the catch. They can then be<br />

pulled up and out.<br />

Seat; is pulled upwards<br />

which folds the chair inwards<br />

for transportation.<br />

Foot-plates; these can fold<br />

upwards.<br />

Foot-plates; Release of this<br />

mechanism enables the<br />

foot-plates to swing outwards.<br />

Evidence<br />

Demonstrate to your supervising therapist that you can dismantle the chair for<br />

transportation.<br />

<strong>Workbook</strong> <strong>15</strong> Page 8


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

<strong>15</strong>.6 Teaching patients to transfer safely in and out of a bed or chair<br />

using appropriate aids<br />

Part of your job may be to help the patient to practice transferring from the bed to the chair<br />

or wheelchair, so that they can become strong enough to do it by themselves.<br />

Activity<br />

Assuming that the patient can get themselves up to sitting over the side of the bed,<br />

before starting to practice the transfers, what safety factors should you think about?<br />

■■<br />

■■<br />

■■<br />

■■<br />

■■<br />

■■<br />

■■<br />

Correct positioning of chair For a lateral transfer, bed to chair, the chair should be<br />

positioned as close to the bed as possible.<br />

Application of brakes You must ensure that any brakes are applied prior to moving the<br />

patient to or from any chair.<br />

Removal of sides of chair The patient may need to practice removing the side of the<br />

chair so he can do this himself. You should be familiar with the release mechanism, and<br />

know how to remove the side of the chair.<br />

Repositioning of footplate Similarly, any footplates should be moved out of the way to<br />

enable the patient to come into or out of the chair. Make sure you know how to do this.<br />

Application of sliding aid/transfer board You may require to assist the patient to use a<br />

sliding aid. The aid may be used to bridge the gap between the chair and bed.<br />

A transfer board or slide sheet may be required However the patient should as much as<br />

possible use his arms and legs to raise his buttocks to transfer to prevent shearing of the skin.<br />

Application and removal of safety belt The patient should use a safety belt when<br />

moving around in the wheelchair. Do not forget to remove before the transfer and<br />

reapply afterwards.<br />

Activity<br />

With your supervising therapist, practice performing chair to bed, and chair to chair<br />

transfers yourself.<br />

Also practise teaching a model the steps to go through to transfer from bed to chair or<br />

chair to chair.<br />

<strong>Workbook</strong> <strong>15</strong> Page 9


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

Evidence<br />

When you are ready, your supervising therapist will supervise you teaching a patient to<br />

transfer.<br />

Depending on where you work this may be a neurological patient or an amputee.<br />

Describe the transfers practiced on your unit.<br />

What difficulties do the patients have?<br />

What precautions must you take?<br />

Remember<br />

You must inform your supervising therapist if there is a change in the condition of the<br />

patient that requires reassessment.<br />

<strong>Workbook</strong> <strong>15</strong> Page 10


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

<strong>15</strong>.7 Teaching a patient to manoeuvre a wheelchair<br />

Patients need to practise using and manoeuvring with the wheelchair.<br />

You may be given the task of supervising their practice.<br />

Activity<br />

Find a wheelchair to practise with.<br />

Have a go at:<br />

■■<br />

■■<br />

■■<br />

■■<br />

moving the chair backwards and forwards<br />

going through doorways<br />

getting close to a bed as if you were about to transfer onto it<br />

going through an obstacle course<br />

Once you feel confident doing this, your supervising therapist will supervise you<br />

helping to teach a patient to perform these manoeuvres.<br />

Acknowledgements<br />

NHS Tayside<br />

<strong>Workbook</strong> <strong>15</strong> Page 11


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

<strong>15</strong>.8 <strong>Transfers</strong> workbook completion<br />

Your supervising physiotherapist will sign your portfolio to indicate that you have<br />

completed this workbook successfully.<br />

Objective Physiotherapist’s signature Date<br />

Describe, demonstrate and<br />

teach the normal sequencing of<br />

movement to assist or facilitate<br />

patients from a lying and from a<br />

sitting position<br />

Assist a patient to move up and<br />

down the bed<br />

Dismantle and reconstruct a<br />

wheelchair for transportation<br />

Assist in teaching patients to transfer<br />

safely in and out of a wheelchair<br />

using appropriate aids<br />

Demonstrate your ability to teach<br />

patients to safely manoeuvre their<br />

wheelchair<br />

Identify change in the patient’s<br />

condition that requires reassessment<br />

Support worker (name)<br />

Support worker’s signature<br />

Physiotherapist (name)<br />

Physiotherapist’s signature<br />

Date<br />

<strong>Workbook</strong> <strong>15</strong> Page 12


NHS Training for Physiotherapy Support Workers<br />

<strong>Workbook</strong> <strong>15</strong> | <strong>Transfers</strong><br />

<strong>15</strong>.9 <strong>Transfers</strong> reflection<br />

Suggested KSF Dimensions: C2, C3, HWB2, HBW7<br />

This form should be placed in the appropriate section of your portfolio.<br />

What did you learn from this module?<br />

How has this influenced your work?<br />

Date module completed<br />

Date module completed<br />

<strong>Workbook</strong> <strong>15</strong> Page 13


Greater Glasgow<br />

and Clyde<br />

Tayside

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