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What is a transfer?
The safe movement of a person from one surface or location to another or from one position to another.
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What are bed mobility activities?
- rolling side to side
- moving up or down in bed
- transitioning from supine to prone
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What are bed mobility activities labeled as for billing purposes?
- pre-transfer activity
- or
- functional mobility training
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What are the levels of assistance needed for transfer, ambulation, or bed mobility?
- Independent (I)
- Modified Independent (Mod. I)
- Stand by assistance (SBA)
- Contact Guard Assistance (CGA)
- Minimal Assistance (Min. asst.)
- Moderate Assistance (Mod. asst.)
- Maximal Assistance (Max. Asst.)
- Dependent
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What are the elements of transfers that need to be documented?
- amount or type of asst.
- number of people asst-ing
- time it took for transfer
- level of safety demonstrated
- level of consistency of performance
- special equipment used
- type of transfer
- specific cues or direction pattern used
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How can you be safe during transfers?
- wear proper shoes
- use a gait belt
- anticipate --> have a back up plan!
- know your surroundings
- does the pt have tubes or drains? where are they?
- know your pt, yourself, and who's helping!
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Organization of pt transfers:
- know the pt. diagnosis
- Know the level of transfer
- Make your own assessments
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Organization of transfer pertaining to the pt
- instruction of:
- direction of movement
- type of transfer
- hand/foot placements
demonstrate!
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Take into consideration for SAFE transfers:
- stay close to the pt. but don't block line of sight
- give clear instructions
- clarify direction of transfer to weak or strong depending on pt
- practice the components of transfer
- USE GAIT BELT
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Precautions for THA pt's:
- AVOID:
- adduction
- rotation
- flexion >90*
- OK:
- hip extension-neutral
- abduction during mobility transfers
- recliner w/c recommended
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Precautions for LBP, Trauma, post op-laminectomy:(Avoid?)
- AVOID:
- lumbar rotation and side bending
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What is ok for LBP, Trauma, post op-laminectomy pt's for transfer?
- trunk flexion
- logrolling w/ hip and knees flexed
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Precautions for LBP, trauma, post op-laminectomy: (Avoid?)
- AVOID:
- DO NOT PULL ON EXTERNAL FIXATOR
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Precaution for Hemiplegia pt:
do not pull on involved LE
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Precaution for Burn pt's:
avoid sheering forces on fragile skin/skin grafts
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Precautions for all orthopedic pt's:
weight bearing status & restrictions
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Types of transfers
- stand pivot
- sitting transfer
- recumbent/ lateral transfer
- floor to chair
- car/toilet/bath transfers
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Know your pt's diagnosis:
NWB
Non-weight bearing
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Know your pt's diagnosis:
TTWB
Toe-touch weight bearing
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Know your pt's diagnosis:
PWB
partial weight bearing
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Know your pt's diagnosis:
WBAT
Weight bearing as tolerated
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