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.
- 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 not be performed on a student who weighs more than 70 pounds.
- Students weighing more than 70 pounds should be transferred using a mechanical lift.
- This weight limit may be less if the patient has other complications such as contractures that make transfers more difficult when lifting near the floor.
- 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
- 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.
- Let the student know when you are beginning a transfer.
- 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 positions themselves in front of the student
- Person Two positions themselves behind the student
- Person One bends from knees and hips and lowers to place both arms under the student’s knees
● Person One interlocks their fingers or grasps their wrists to create a stronger hold - Person Two asks the student to cross their arms and person two places their arms under the student’s armpits reaching forward to grasp their own wrists firmly
- 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
- Person One and Person Two walk to where the student is to be placed
● When walking, use a wide base of support
● When walking, move using legs and feet and not by twisting the spine - Person One counts to three and Person One and Person Two lower the student to the floor, bending from their knees and hips
- 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
- Wash hands
Two-Person Transfer of a Student who is Wheelchair Bound
Floor to Wheelchair
- Wash your hands
- Explain the procedure to student at their level of understanding
- Always minimize the distance between transfer points
- 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
- Person One positions themselves in front of the student
- Person Two positions themselves behind the student
- Person One lowers to place both of their arms under the student’s knees
- Person One interlocks their fingers or grasps their wrists to create a stronger hold
- Person Two asks the student to cross their arms
- Person Two places their arms under the student’s armpits, reaching forward to grasp their own wrists firmly
- Person One then informs Person Two and the student to lift the student together on the count of three
- Person One and Person Two lift the student and straighten their knees and hips and walk together to the wheelchair
● When walking, use a wide base of support
● When walking, move using legs and feet and not by twisting the spine - Person One counts to three and Person One and Person Two lower the student into the wheelchair, bending from the knees and hips
- Ask the student to fasten their seat belt
● If student is unable, Person One fastens 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 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
Duchenne Therapy Network. (2015, October 27). Video blog 16- Transferring someone with Duchenne- CureDuchenne cares education series. Retrieved June 26, 2023, from https://www.youtube.com/watch?v=1VJKVl8aDPw&t
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/
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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