Itís important to understand that there is an element of risk in virtually every patient transfer methodology, which is why we continuously stress the need to properly assess each patient transfer in advance in order to prevent unnecessary injuries to caregivers or patients. Most pivot transfers require good caregiver skill because they place a great deal of emphasis on the patientís ability to understand what they have to do (namely stand and bear their own weight) and cooperate with the caregiver during the entire transfer process. Note: assess the patientís ability to stand, and understand, before proceeding with a pivot transfer!
That said, pivot transfers and pivot transfer boards are commonly encountered in healthcare, thus itís really a matter of conditioning caregivers regarding when to use them and how to avoid injuries. Following are three observations for you to consider:
- Sliding boards are generally used in conjunction with gait belts for safety purposes. Many of the newer versions of sliding boards have pivoting devices that allow the patient to slide easily along the board without incurring tissue damage and with no lifting involved. These devices are particularly useful for difficult transfers such as from wheelchair to automobile seat. They can be used safely but you should become familiar with, and follow the manufacturerís instructions.
- Two-person pivot transfers are used to transfer patients between two seating surfaces such as a bed and a wheelchair. These maneuvers are moderately risky and are often performed with the assistance of a gait belt or transfer belt. The caregiver facing the patientís front may deploy a gait belt and would use her weight to counterbalance the patientís weight while the caregiver facing the patientís rear would guide the patient from one seat to another. The rear caregiver is generally at greater risk of injury because she may be in an awkward posture and thus more prone to try to prevent a fall if the patient begins to lose their balance. Note: in order to utilize this technique effectively, the patient must be able to bear their own weight.
- Single-person pivot transfers involve high risk for both the caregiver and the patient. Two techniques are possible, one with the caregiver facing the patient and placing her hands around the patientís waist, and the other placing her hands on a gait belt which is around the patientís waist. One significant danger in this transfer method is that the patient may be inclined to place their hands around the caregiverís neck. Then, in the event the patient begins to slip or fall, this places the caregiver at significant risk of injury to the back or neck. Note: Do NOT attempt to lift the patient from their seat, and do NOT attempt this maneuver if the patient is unable to support their own weight and move to a full standing position.
The Lift Doctor*