Skin Safety with Bed/Chair Transfers

Teresa Bonham, P.T., Denials Coordinator

Bed-WC/Chair transfers: Things to Consider to Reduce Risk for Skin Tears

1. Assess skin prior to mobility- Is it thin? Are skin tears already present?
    
2. Is the skin loose? (Can be easily caught on bed or WC)
    
3. Is the patient taking blood thinners? ( bruise easily, skin may become thin and fragile)
    
4. Are there bedrails? Do they retract under the bed? (if not, pt needs to scoot forward more to avoid calf contact with rail) Recommend having a barrier over rails to cover any rough areas of the rails before pt transfers( sheet or towel works well-secure under mattress to prevent sliding)
    
5. Is the resident able to touch their feet to the floor when sitting at the edge of the bed? If not, can they stand and step off a step before turning to the chair/wc? If not, use a lift or slide board unless a pivot disc is available and the patient is able to effectively place their feet on the disc and be assisted to partial standing.
    
6. Do the WC legs remove? If not, cover with towel to prevent pts legs from scraping on the leg rests.

Plan ahead, be safe, do no harm. Remember- shear and friction cause damage. Clear all body parts from the bed before pivoting and the risk of injury is greatly minimized.