One Person Transfer between Wheelchair and Chair

One-Person Transfer of a Student who is Wheelchair Bound
Transfer from Wheelchair to a Chair

Considerations:
● When possible, transfers of students who are wheelchair-bound and have minimal ability to assist with the transfer should be completed using a mechanical lift to avoid injury to the student and/or school staff.
o School staff must be properly trained on how to use mechanical lifts and be able to demonstrate competency prior to use.
● A one-person transfer from wheelchair to the floor (and back) should only be performed on a student who can bear some weight.
o Students who are unable to bear some of their own weight should be transferred using a mechanical lift.
o Each situation should be evaluated individually, in collaboration with the student’s family and health care provider, to determine if this procedure is appropriate.
● Always minimize the distance between the transfer points.
● Allow the student to assist in the procedure as much as possible, to foster independence (i.e. moving their wheelchair into position, locking the brakes, etc.).
● If a student starts to fall during a transfer, ease them down to the nearest surface.
o Do not try to stretch to complete the transfer as you will likely lose your balance or strain your muscles injuring both yourself and the student you are transferring.
● Adaptive equipment, such as positioning chairs, can only be used if prescribed by a physical therapist, occupational therapist or a health care provider.
● Always communicate with the student and other staff while completing a transfer.
o Let the student know when you are beginning a transfer.
o Check with the student after the transfer to ensure they are comfortably and securely in place.

Supplies:
● Student’s Individualized Health Care Plan (IHCP) and health care provider’s orders, if necessary
● Parent/Guardian authorization form, if necessary

Proper Body Mechanics:
● Keep head, neck, and trunk in the same plane
● Tighten your core muscles and tuck your pelvis
● Place feet shoulder-width apart
● Bend at your knees, not your waist
● During the transfer, keep the student close to your body
● Turn your entire body, not just your back

Procedure:

1. Wash hands
2. Explain the procedure to student at their level of understanding
3. Always minimize the distance between transfer points
4. If the student is able, ask them to move their wheelchair to the proper position for the transfer, if not, inform the student of your intention and move the wheelchair into position yourself
5. Once in position, have the student lock the brakes on the wheelchair
   ● If necessary, lock the brakes yourself
6. Remove equipment and supports that may get in the way
   ● For example, remove or adjust one side support or arm rest, if needed
7. Loosen foot straps and move the footrests to the side or remove, if possible
8. If able, have the student unfasten their seat belt or unfasten the seat belt for them
9. Inform the student that it is time to transfer
10. Stand in front of the student
11. Spread your feet about shoulder-width apart
12. Flex your hips and knees
13. Have the student slide their buttocks to the edge of the wheelchair until their feet touch the floor
14. Position yourself as close to the student as possible, with your feet positioned on the outside of the student’s feet
15. Have the student lean forward
16. Place your arms under the student’s armpits and around their back
17. Grasp your wrist to create a stronger hold
18. Instruct the student that they should move to stand up on the count of three
19. On the count of three, assist the student in moving to a standing position
20. Pivot your feet and legs and assist the student to turn until the student feels the chair against the back of their legs
21. Position the student in front of the chair
22. Instruct the student to bend their legs to sit down on the count of three
23. Count to three and assist the student into a sitting position
24. Brace the student’s knees with your knees as you assist the student in lowering down into the chair
    ● Be sure to flex your knees and hips while you lower the student
    ● Do not bend at your back
25. Ensure that the student is comfortably and safely positioned before moving away
26. Release the brakes on the wheelchair and move it to an appropriate location until it is needed again

One-Person Transfer of a Student who is Wheelchair Bound
Chair to Wheelchair

1. Wash your hands
2. Position the wheelchair as close to the student as possible and lock the brakes
3. Remove all removable parts of the wheelchair that interfere with the transfer
4. Inform the student that it is time to transfer
5. Position yourself in front of the student
6. Place your feet shoulder-width apart
7. Flex your hips and knees
8. Have the student slide their buttocks to the edge of the chair until their feet touch the floor
9. Position yourself as close to the student as possible, with your feet positioned on the outside of the student’s feet
10. Have the student lean forward
11. Place your arms under the student’s armpits and around their back
12. Grasp your wrist to create a stronger hold
13. Instruct the student that they should move to stand up on the count of three
14. On the count of three, assist the student in moving to a standing position
15. Pivot your feet and legs and assist the student to turn until the student feels the chair against the back of their legs
16. Position the student in front of the wheelchair
17. Instruct the student to bend their legs to sit down on the count of three
18. Count to three and assist the student into a sitting position
19. Have student reach back with their arms and hands to grasp the sides of the wheelchair
20. Brace the student’s knees with your knees as you assist the student in lowering down into the wheelchair
21. Be sure to flex your knees and hips while you lower the student
22. Do not bend at your back
23. Once the student is securely positioned in the wheelchair, ask the student to fasten their seat belt
    ● If student is unable, fasten the student’s seat belt
24. Position any supports that were removed from the wheelchair
25. Wash hands
26. Document assessment, intervention, and outcomes in student’s health care record
27. Report any problems or concerns to parents/guardian and health care provider

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References:

Academy of Pediatric Physical Therapy. (2018). Fact sheet safe student lifting and transfers in the school setting: A decision-making guide. Retrieved June 26, 2023, from  https://pediatricapta.org/includes/fact-sheets/pdfs/FactSheet_SafeStudentLiftingandTransfersSchoolSetting_2018.pdf

American Academy of Orthopaedic Surgeons. (2020, September). Lifting techniques for home caregivers. Retrieved June 26, 2023, from https://orthoinfo.aaos.org/en/staying-healthy/lifting-techniques-for-home-caregivers

Lynn, P. (2019). Transferring a patient from the bed to a chair. In Skill checklists for Taylor’s clinical nursing skills. A nursing process approach. (5th ed.). (pp. 202-203).

National Institute for Occupational Safety and Health National Institute for Occupational Safety and Health (NIOSH). (2023, March 9). Safe patient handling and mobility (SPHM). Retrieved June 26, 2023, from https://www.cdc.gov/niosh/topics/safepatient/default.html

Pediatric Home Services. (2019, January 4). Techniques for safe lifting and carrying of patients. Retrieved June 26, 2023, from https://www.pediatrichomeservice.com/blog/safe-lifting-and-carrying/

Wisconsin Improving School Health Services Project. (n.d.). Transfers. In The Care of the Student with Special Healthcare Needs. Retrieved June 26, 2023, from https://media.dpi.wi.gov/sspw/av/uaptraining-WISHes/story_html5.html

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Acknowledgment of Reviewers:

Angie Bulmahn, MSN, RN, NCSN
School Nurse Specialist
Missouri Department of Health and Senior Services

Marjorie Cole, MSN, RN, FASHA
State School Nurse Consultant
Missouri Department of Health and Senior Services

Renee Falkner, BSN, RN
School Nurse Supervision Specialist | Therapylog

Katherine Park, DNP, RN, NCSN
Nationally Certified School Nurse, Pierremont Elementary
Adjunct Professor, Maryville University School of Nursing

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Page last updated February 20, 2024
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The information and materials presented in this Website are intended for informational purposes only and are not designed to diagnose or treat a health problem or disease, or assist in diagnosis or treatment of the same. The information is not intended to substitute for, supplement or replace clinical judgment. If there are any concerns or questions about or relating to a nursing or medical procedure, contact the individual’s healthcare provider. The information provided on this Website is not intended to be a substitute for medical orders and persons without the proper education, training, supervision and/or licensure should not perform the procedures.

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