Patient transfer is an important part of patient care. It may involve moving the patient within the same facility or another facility to receive a required treatment. The main purpose of the transferring is maintaining the continuity of medical care and to avoid the risks by transporting the patient with a professional team. In this essay, I will demonstrate the role of the radiographer during the patient transfer and discussing the risks and their causes, safety measures during patient transfer, clinical reasons of patient immobility and describing patient transfer aids and the risks, advantages, disadvantages of it.
Patient transfer & Radiographer role
The transferring of the patient is required when the patient needs to move from one place to another in the hospital or move to another hospital to receive better care. This procedure is important because sometimes the patient believes that he can walk to the imaging department without assistance. If an ambulatory patient faint or becomes weak in the corridor or elevator during his way, there is no safe way to deal with it. The radiographer may be called to assist or transfer the patient from a hospital room to the imaging department to maintain the procedure. There are important precautions that need to be maintained. The radiographer should identify himself to the patient and the reason for being there. Ask the patient to see their identification because sometimes the patient has been transferred to another room since the request was submitted. Request information concerning the ability to respond with the physical request of the procedure and any precautions to be taken related to patient mobility. (Ashish Kulshrestha, 2016)
There are many factors which can make the patient handling activities dangerous by increasing the risk of injury. These risk factors related to the environment. By slipping, uneven work surfaces, limitation of the space and equipment. Or Other risks, for instance, no assistance available and lack of training or knowledge. Safety precautionary should be maintained to minimize the risk and to protect the patient from any suspected hazard. Which includes: 1- seeking for assistant when necessary. 2- the patient should be close as possible to the caregiver. 3- explaining the procedure to the patient and encouraging him to cooperate as much as possible. 4- keep the same correct posture during the lifting and get a good grip by using the whole hand. 5- wearing suitable footwear and clothing. (CLINICAL PROCEDURES FOR SAFER PATIENT CARE)
The patient can be transferred using wheelchair, stretcher, draw sheet, slider boards and sliding mats based on their clinical condition and nature of mobility. As an example:
o Traumatic brain injuries can affect your brain cells. More severe traumatic injuries may result on torn of the tissues, bleeding and other physical damages. It may result in temporary or long-term complications or death. The symptoms of the brain injury can be physical and psychological such as: 1-Headachr 2- Fatigue ,3- problem with speaking, 4- Dizziness, 5- loss of consciousness for few secs or mins.in the other hand mental symptoms 1- memory problems, 2-mood change, 3- depression. They are usually caused by common events such as Falls, vehicle accidents, violence and sports injuries. Severe brain trauma can result in a change of the patient state including, Coma: unaware of anything and unable to respond to any motive, mainly conscious state: severe consciousness and self-awareness on the same time, and brain death: no activity in the brain. They use stretcher transfer for this condition. (Mayo Clinic Staff, 2018)
o Patients with lower limb fracture, such as broken femur is a break in one of the leg bones. Common causes include sport injuries, falls and vehicle accidents. Treatment of the broken leg may require surgery to implant devices into the broken bone to maintain the right alignment based on the location and the severity of the injury. The symptoms of a broken leg may include:
? Inability to walk
? Severe pain
A broken leg can’t always be prevented, but there are tips that may reduce the risk: 1- eating calcium- rich food (cheese, milk and yogurt), 2- wearing proper shoes, 3- swimming or biking activities can prevent stress fractur. They can transfer the patient by wheelchair. (Mayo Clinic Staff, 2018)
o Coma patient are unconsciousness than can be caused by many problems: stroke, drug intoxication, diabetes and brain tumor. A coma is medical emergency, so it needs fast action and right treatment, to maintain the best treatment the doctors should order blood examination and brain CT. the coma usually lasts for longer than several weeks. The causes of the coma are 1- lack of oxygen, 2-infections, 3- toxins, 4- car accidents, 5- alcohol, 6- tumors. Patents in coma should be transfer by stretcher. (Mayo Clinic Staff, 2018)
Patient transfer aid
Transfer assist devices are used to maintain safe transferring a patient and eliminate the risk factors that can lead to patient injury. Patient should be motivated to move themselves. The goal of transfer, whether it is rehabilitation or moving from one place to another.
o Draw and slider sheet are made of low-friction fabrics or gel filled, may be used in pairs, singly, or folded. It can be used to moving the patient up in bed, turn patient to their side of the bed, transferring patient from one surface to another (bed to stretcher)
? Advantages: 1-simple, 2- avoiding the need to lift the patient manually
? Disadvantages: 1- may cause pain for patients how have pressure sores, 2- heavy patient may still require extra force to move, 3- the transfer needs two caregivers.
o Transfer belts comes in many sizes and shapes, they usually have handles. Caregivers often wear the belt around their own waist to make sure it is readily available. Can be used during assisted walking and to guide the patient along transfer.
? Advantages: 1- caregivers do not need to hold the patient’s clothing or limbs, 2- caregivers can work in upright posture
? Disadvantages: 1- too wide belt may affect patient ability to lean, 2- the caregiver are placed in risk where the patient is allowed to hold around the caregiver’s neck, 3- narrow, unpadded belts may dig into the patient’s waist.
o Slide transfer borders are made of wood or plastic, some of the boards have rollers, while the other have fabric. These borders can be used only for patients who can power themselves by rolling or sliding along the border. Some of the pressure require the caregiver to push the boarder to accomplish the transfer.it can be used to cover the gaps between two surfaces such as bed and wheelchair, chair and wheelchair and the rolling slide can be used when transferring supine patient from bed to stretchers.
? Advantages: 1- some patient can transfer themselves, they will avoid the need for caregiver 2- caregivers do not need to lift manually.
? Disadvantages: 1- may put the caregiver in high risk of Musculoskeletal Injury when they use this type of transferring to patient who can’t assist themselves 2-there is no handles for positioning or carrying the borders (Transfer assist devices for safer handling of patients)
• Risks related to the transfer aid of the patient:
? Slipping, and falling hazard
? Lack of knowledge
? Difficult to predict the patient’s reaction while handling
? Space limitation
? Gap between the two surfaces (Silvia C, 2003)
Patients transfer is an important way to move a patient from place to another. The transformation should begin after having information about the patient and knowing the risks involved, it can be maintained by wheelchair or stretcher, based on the patient condition. every condition has a different degree of mobilities. Some of the patients believe that they are able to walk but to avoid the risk from happening we should maintain the transformation. Transfer personnel, an important factor in the safe transfer. The transfer personnel should be qualified to manage any complication. To maintain the best patient transfer and to protect the patient from the risks, we should minimize it by knowing the problem or the cause of the risk and try to solve it. In the end patient can be transferred from bed to stretcher, chair to wheelchair by transfer aid such as slider border, slider sheet and the belt based on their condition. (Singh, 2016)
In conclusion, to maintain the best care and transferring of the patient, the caregiver should know the history of the patent, what risks can be accruing during the procedure and try to minimize it. Maintain the best equipment and transfer aid that are suitable for the patient condition.