Two Person Transfer between Wheelchair and Chair

Other

Two-Person Transfer of a Student who is Wheelchair Bound
Transfer from Wheelchair to the 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 list 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 two-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:

Wash hands
Explain the procedure to student at their level of understanding
Always minimize the distance between transfer points
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
Once in position, have the student lock the brakes on the wheelchair
● If necessary, lock the brakes yourself
Remove equipment and supports that may get in the way
● For example, remove or adjust one side support or arm rest, if needed
Loosen foot straps and move the footrests to the side or remove, if possible
If able, have the student unfasten their seat belt or unfasten the seat belt for them
Inform the student that it is time to transfer
Person One and Person Two stand on either side of the wheelchair
Have the student slide their buttocks to the edge of the wheelchair until their feet touch the floor
Make sure the student’s feet are slightly underneath them
Person One and Person Two each take their arm and hand that is closest to the student and slide it under the student’s armpit, on either side, bending at the elbow
Person One then informs Person Two and the student to lift the student together on the count of three
On the count of three, Person One and Person Two lift the student using their legs and buttock muscles to lift
● If the student is able, have them push off on the wheelchair armrest with their hands
Pause and check in with the student to ensure that they are feeling stable and are ready to continue the transfer
Person One and Person Two Pivot their feet and legs and assist the student to turn until the student feels the chair against the back of their legs
Position the student in front of the chair
Instruct the student to bend their legs to sit down on the count of three
Person One counts to three and Person One and Person Two assist the student into a sitting position
● Be sure to flex your knees and hips while you lower the student
● Do not bend at your back
Ensure that the student is comfortably and safely positioned before moving away
Release the brakes on the wheelchair and move it to an appropriate location until it is needed again

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

Wash your hands
Position the wheelchair as close to the student as possible and lock the brakes
Remove all removable parts of the wheelchair that interfere with the transfer
Inform the student that it is time to transfer
Person One and Person Two stand on either side of the chair
Have the student slide their buttocks to the edge of the chair until their feet touch the floor
Make sure the student’s feet are slightly underneath them
Person One and Person Two each take their arm and hand that is closest to the student and slide it under the student’s armpit, on either side, bending at the elbow
Person One then informs Person Two and the student to lift the student together on the count of three
On the count of three, Person One and Person Two lift the student using their legs and buttock muscles to lift
Pause and check in with the student to ensure that they are feeling stable and are ready to continue the transfer
Person One and Person Two Pivot their feet and legs and assist the student to turn until the student feels the wheelchair against the back of their legs
Position the student in front of the wheelchair
Instruct the student to bend their legs to sit down on the count of three
Person One counts to three and Person One and Person Two assist the student into the wheelchair
● Be sure to flex your knees and hips while you lower the student
● Do not bend at your back
If the student is able, have student reach back with their arms and hands to grasp the sides of the wheelchair
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
Position any supports that were removed from the wheelchair
Wash hands
Document assessment, intervention, and outcomes in student’s health care record
Report any problems or concerns to parents/guardian and health care provider

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 h ttps://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).

McCormick Care Group. (2020, May 14). Assisting with a two-person transfer. . Retrieved June 26, 2023, from https://www.youtube.com/watch?v=o8iR_yuzE58&t=160s

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

St. Louis Digital Media Studio. (2020). 2 person manual transfer from wheelchair to bed side by side handling technique. . Retrieved June 26, 2023, from https://www.youtube.com/watch?v=iPBVD9_cJEU

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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