Transfer Resident from Bed to Wheelchair

Care Plan: Transfer a resident from bed into a wheelchair using pivot transfer technique and a transfer/gait belt. The resident will be lying in a bed and is able to stand but cannot take steps.


Click on each question below to view the answer…

What if the patient doesn’t have shoes?

For the exam, the patient will have shoes available (they wore them into the testing center).  In a clinical setting, most patients have shoes in their closet that may be worn for transferring.  Ask the patient where their shoes are located or look in the closet and bedside cabinet.  If the patient has no shoes, notify the nurse.

Can the patient help with this skill?

For the exam, the patient can stand with assistance, but cannot take steps.  Therefore, this skill must be accomplished as a pivot transfer, where the CNA lifts the patient to a standing position and pivots them into the wheelchair in one smooth motion.

Isn’t leaving a patient in a locked wheelchair considered a restraint?

No.  It is a safety measure.  If the wheelchair is left unlocked and the patient tries to get up, the wheelchair can roll out from under him and he can fall.  If the floor is uneven, the wheelchair can roll the patient into a wall or furniture. And wandering dementia patients may take your wheelchair-bound patient for a ride and leave them somewhere unexpected.  If the patient is able to propel themselves, they can simply unlock the wheelchair and go.  Therefore it is not considered a restraint.

Does it matter which way the patient faces when you leave them during the exam?

No.  Although it is preferable to leave the patient facing something interesting (like a window, the TV or transported into the activity room or hallway), this point is not graded for the exam.  The exam is set up to demonstrate only a small portion of your daily activities with the patient, and the exam knows that in a clinical setting, you are probably getting the patient out of bed for a particular reason (meals, therapy, activities, testing, etc).  Therefore, which direction the patient faces is not important, since in real life the skill doesn’t stop there.

Can you elevate the head of the bed to make it easier to swing the patient around to a sitting position?

Yes.  You may assist the patient to a sitting position with the head of the bed flat or in a raised position.  Whichever method works best for you.

Do I have to check to make sure the bed is locked before performing the skill?

You can quickly determine if they are locked by lightly bumping against the bed during your opening. If the bed moves, you will need to lock it before proceeding. For the exam, the bed is in the locked position and remains that way throughout the skills. If it was not locked, when I lean against it to swing the patient into a sitting position on the side of the bed, it would have rolled away.