Safe and Easy Transfer Skills for Transferring Patients from Bed to Wheelchair.

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The purpose of this study was to find easy transfer skills for nurses and stroke patients with hemiplegia when there was a difference in height between patient and nurse. The authors videotaped nurses transferring a normal subject from bed to wheelchair, and a motion analysis was done using three-dimensional biomechanical analysis and a force plate. The subjects simulated a patient with hemiplegic paralysis of the right side. The authors analyzed practical skills for assisting patients in standing up, turning and sitting down.First, we recorded and analyzed the skills of expert nurses working in a rehabilitation center and nursing students. Movements were then classified as "lifting", "extending the hips" and "bending the knee" to assist getting up and sitting down. The characteristic movement exhibited by expert nurses was "bending the knee" to assist getting up and sitting down. We also observed the motions used by the nurses to prevent lower back pain and to support the patient's natural movements. We believe that these skills are useful in the instruction of transfer skills for nurses and nursing students.When both taller and shorter students imitated the expert nurses' movements in transferring subjects from bed to wheelchair, they could assist transferring easily. Then we compared the nurses' lower back work load when the bottom of the bed was at a height of 120%, 140% and 160% of the patient's lower leg length. A height of 140% was the most appropriate for minimum work load. When there was a difference in height between patient and nurse, nurses experienced difficulty in assisting transfer from bed to wheelchair. But in such cases, if nurses imitated expert nurses' transfer movements and adjusted the height of the bed, they were able to transfer patients easily.