Which of the following should be one of the first steps in any patient transfer?

Moving Patients from Bed to Wheelchair

Using a transfer belt can help make moving patients safer.

Patient safety is often the main concern when moving patients from bed. But remember not to lift at the expense of your own back. This transfer often requires the patient's help, so clear communication is essential. If the patient can’t help much, you’ll need two peopl or a fully body sling lift.

Remember: When patients are weak, brace your knees against theirs to keep their legs from buckling. Also, transfer toward patient’s stronger side if possible.

Step 1.  Sit the patient up

• Position and lock the wheelchair close to the bed. Remove the armrest nearest to the bed, and swing away both leg rests.
• Help the patient turn onto his or her side, facing the wheelchair.
• Put an arm under the patient’s neck with your hand supporting the shoulder blade; put your other hand under the knees.
• Swing the patient's legs over the edge of the bed, helping the patient to sit up.

Step 2.  Stand the patient up

• Have the patient scoot to the edge of the bed.
• Assist the patient in putting on skid proof socks or shoes.
• 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.
• Supporting the leg farthest from the wheelchair between your legs, lean back, shift your weight, and lift.

Step 3.  Pivot toward chair

• Have the patient pivot toward the chair, as you continue to clasp your hands around the patient.
• A helper can support the wheelchair or patient from behind.

Step 4.  Sit the patient down

• As the patient bends toward you, bend your knees and lower the patient into the back of the wheelchair.
• A helper may position the patient’s buttocks and support the chair.
• Reposition the foot rests and the patient's feet.

StayWell last reviewed this educational content on 3/1/2018

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Follow these steps to move a patient from bed to a wheelchair. The technique below assumes the patient can stand on at least one leg.

If the patient cannot use at least one leg, you will need to use a lift to transfer the patient.

Think through the steps before you act and get help if you need it. If you are not able to support the patient by yourself, you could injure yourself and the patient.

Make sure any loose rugs are out of the way to prevent slipping. You may want to put non-skid socks or shoes on the patient's feet if the patient needs to step onto a slippery surface.

The following steps should be followed:

• Explain the steps to the patient.
• Park the wheelchair next to the bed, close to you.
• Put the brakes on and move the footrests out of the way.

Before transferring into the wheelchair, the patient must be sitting.

Allow the patient to sit for a few moments, in case the patient feels dizzy when first sitting up.

The following steps should be followed when getting ready to transfer a patient:

• To get the patient into a seated position, roll the patient onto the same side as the wheelchair.
• Put one of your arms under the patient's shoulders and one behind the knees. Bend your knees.
• Swing the patient's feet off the edge of the bed and use the momentum to help the patient into a sitting position.
• Move the patient to the edge of the bed and lower the bed so the patient's feet are touching the ground.

If you have a gait belt, place it on the patient to help you get a grip during the transfer. During the turn, the patient can either hold onto you or reach for the wheelchair. They should not wrap their arms around your head or neck.

Stand as close as you can to the patient, reach around the chest, and lock your hands behind the patient or grab the gait belt.

The following steps should be followed:

• Place the patient's outside leg (the one farthest from the wheelchair) between your knees for support. Bend your knees and keep your back straight.
• Count to three and slowly stand up. Use your legs to lift.
• At the same time, the patient should place their hands by their sides and help push off the bed.
• The patient should help support their weight on their good leg during the transfer.
• Pivot towards the wheelchair, moving your feet so your back is aligned with your hips.
• Once the patient's legs are touching the seat of the wheelchair, bend your knees to lower the patient into the seat. At the same time, ask the patient to reach for the wheelchair armrest.

If the patient starts to fall during the transfer, lower the person to the nearest flat surface, bed, chair or floor.

Pivot turn; Transfer from bed to wheelchair

American Red Cross. Assisting with positioning and transferring. In: American Red Cross. American Red Cross Nurse Assistant Training Textbook. 4th ed. American National Red Cross; 2018:chap 11.

Bergman R, De Jesus O. Patient care transfer techniques. [Updated 2021 Oct 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: www.ncbi.nlm.nih.gov/books/NBK564305.

Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M. Body mechanics and positioning. In: Smith SF, Duell DJ, Martin BC, Gonzalez L, Aebersold M, eds. Clinical Nursing Skills: Basic to Advanced Skills. 9th ed. New York, NY: Pearson; 2017:chap 12.

Timby BK. Assisting the inactive client. In: Timby BK, ed. Fundamentals of nursing skills and concepts. 11th ed. Philadelphia, PA: Wolters Kluwer Health: Lippincott Williams & Wilkens; 2017:unit 6.

Updated by: Jennifer K. Mannheim, ARNP, Medical Staff, Department of Psychiatry and Behavioral Health, Seattle Children's Hospital, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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