Moving a patient, whether repositioning in a bed or transferring to a chair, requires careful attention to detail to ensure the safety of both the patient and the caregiver. Patient transfer carries inherent risks of injury, falls, and discomfort if not performed correctly. To prevent harm, it is important to understand and strictly avoid common mistakes during every stage of the moving process. Patient safety is the highest priority during these physically demanding actions.
Neglecting Pre-Move Safety Checks
Failing to prepare the environment and equipment before a transfer is a common oversight that increases the risk of accidents. A fundamental mistake is not securing all moving parts of equipment, such as neglecting to lock the wheels on a bed, gurney, or wheelchair, which can cause sudden movement. The pathway for the move must also be completely clear of obstacles, like loose rugs, clutter, or trailing cords, to prevent tripping hazards for both the patient and the assistant.
Another error involves the mismanagement of medical tubing and lines attached to the patient. Before initiating a move, all intravenous (IV) lines, drainage bags, and catheters must be identified, managed, and secured to prevent snagging, kinking, or dislodgement. Dislodging a line, such as an IV catheter, can cause pain and complications, while a snagged tube can dangerously tug on the patient or equipment. Additionally, ensure that all necessary equipment, such as a transfer belt or mechanical lift, is immediately available and in proper working order before the move begins.
Using Improper Lifting Techniques
Relying on poor body mechanics to manually lift or move a patient is a dangerous mistake and the primary cause of back and joint strain injuries for caregivers. Caregivers should never lift with their back; instead, they must bend at the hips and knees, keeping the back straight to engage the leg muscles. Holding the patient as close to the body as possible also helps maintain the caregiver’s center of gravity and reduces strain.
Caregivers must avoid twisting the torso while bearing the patient’s weight, as this rotational force stresses the spinal discs and ligaments. Instead of twisting, the caregiver should pivot their entire body by moving their feet to change direction. Attempting to move a patient who is too heavy or physically unstable without adequate assistance or mechanical aids is a high-risk error. If the patient cannot assist or the caregiver doubts their capacity, a mechanical lift or another person must be utilized.
Causing Skin Damage During Repositioning
Creating friction and shearing forces that damage the patient’s skin and underlying tissue is a mistake often overlooked during quick movements. Friction occurs when the skin is rubbed across a surface, such as dragging a patient over bedsheets, which can strip away the protective outer layer of skin. This can lead to open sores, sometimes referred to as a friction burn.
Shearing is an injury that happens when the skin and superficial tissue move in one direction, but the deep tissue and bone remain stationary, stretching and tearing the blood vessels. This often occurs when a patient is pulled up in bed or slides down while the head of the bed is elevated. To prevent these injuries, caregivers must avoid dragging the patient and instead use low-friction devices like draw sheets or slide sheets to lift and glide the person. Keeping the head of the bed at or below a 30-degree angle, unless medically necessary, also reduces the shearing forces that cause sliding.
Ignoring Patient Feedback and Limitations
A non-physical but equally dangerous mistake is neglecting to communicate with the patient or ignoring their verbal and non-verbal cues during a move. Before starting, the caregiver must clearly explain the entire plan to the patient, which helps coordinate efforts and reduce anxiety. Proceeding with a transfer when the patient expresses pain, sudden dizziness, or shortness of breath is a serious error that can lead to falls or injury.
The patient’s feedback is an invaluable safety check, as they are the first to feel when a movement causes strain or discomfort. Caregivers should avoid forcing a movement past a patient’s stated physical limitation or pain threshold, which risks soft tissue damage or bone fracture. Ignoring signs of distress, such as pallor, increased respiratory rate, or sweating, suggests the patient is not clinically stable for the transfer. The move must be a collaborative effort that respects the patient’s current physical state, ensuring they can assist with the move as much as safely possible.