Transferring a Patient From the Bed to a Chair

Goal: The transfer is accomplished without injury to patient or nurse and the patient remains free of any complications of immobility.

1. Review the medical record and nursing plan of care for conditions that may influence the patient’s ability to move or to be positioned. Assess for tubes, IV lines, incisions, or equipment that may alter the positioning procedure. Identify any movement limitations. Consult patient-handling algorithm, if available, to plan appropriate approach to moving the patient.

2. Perform hand hygiene and put on PPE, as indicated.

3. Identify the patient. Explain the procedure to the patient.

4. If needed, move equipment to make room for the chair. Close curtains around bed and close the door to the room, if possible.

5. Place the bed in the lowest position. Raise the head of the bed to a sitting position, or as high as the patient can tolerate.

6. Make sure the bed brakes are locked. Put the chair next to the bed. If available, lock the brakes of the chair. If the chair does not have brakes, brace the chair against a secure object.

7. Encourage the patient to make use of a stand-assist aid, either freestanding or attached to the side of the bed, if available, to move to the side of the bed and to a side-lying position, facing the side of the bed on which the patient will sit.

8. Lower the side rail, if necessary, and stand near the patient’s hips. Stand with your legs shoulder width apart with one foot near the head of the bed, slightly in front of the other foot.

9. Encourage the patient to make use of the stand-assist device. Assist the patient to sit up on the side of the bed; ask the patient to swing his or her legs over the side of the bed. At the same time, pivot on your back leg to lift the patient’s trunk and shoulders. Keep your back straight; avoid twisting.

10. Stand in front of the patient, and assess for any balance problems or complaints of dizziness. Allow the patient’s legs to dangle a few minutes before continuing.

11. Assist the patient to put on a robe, as necessary, and nonskid footwear.

12. Wrap the gait belt around the patient’s waist, based on assessed need and facility policy.

13. Stand facing the patient. Spread your feet about shoulder width apart and flex your hips and knees.

14. Ask the patient to slide his or her buttocks to the edge of the bed until the feet touch the floor. Position yourself as close as possible to the patient, with your foot positioned on the outside of the patient’s foot. If a second staff person is assisting, have him or her assume a similar position.

15. Encourage the patient to make use of the stand-assist device. If necessary, have second staff person grasp gait belt on opposite side. Using the gait belt, assist the patient to stand. Rock back and forth while counting to three. On the count of three, use your legs (not your back) to help raise the patient to a standing position. If indicated, brace your front knee against the patient’s weak extremity as he or she stands. Assess the patient’s balance and leg strength. If the
patient is weak or unsteady, return the patient to bed.

16. Pivot on your back foot and assist the patient to turn until the patient feels the chair against his or her legs.

17. Ask the patient to use an arm to steady him- or herself on the arm of the chair while slowly lowering to a sitting position. Continue to brace the patient’s knees with your knees and hold the gait belt. Flex your hips and knees when helping the patient sit in the chair.

18. Assess the patient’s alignment in the chair. Remove gait belt, if desired. Depending on patient comfort, it could be left in place to use when returning to bed. Cover with a blanket, if needed. Make sure call bell and other necessary items are within easy reach.

19. Clean transfer aids per facility policy, if not indicated for single patient use. Remove gloves and any other PPE, if used. Perform hand hygiene.