Keep the patient in good alignment and protect from injury while being moved. The use of safe patient handling devices and techniques is critical in the prevention of patient care-related injuries.

Follow these recommended guidelines when moving and transferring patients:

• Assess the patient. Know the patient's medical diagnosis and health issues, capabilities, and any movement not allowed. Apply braces or any device the patient wears before helping the patient from the bed.
• Assess the patient's ability to assist with the planned movement. Encourage the patient to assist in own transfers. Encouraging the patient to perform tasks that are within their capabilities promotes independence. Eliminating or reducing unnecessary tasks by the nurse reduces the risk of injury.
• Assess the patient's ability to understand instructions and collaborate with the staff to achieve the movement (see Box 9-1 in Skill 9-1 for general guidelines related to mobility and safe handling of people with dementia).
• Ensure sufficient staff is available and present to move the patient safely.
• Assess the area for clutter, accessibility to the patient, and availability of devices. Remove any obstacles that may make moving and transferring inconvenient.
• Use a screening or assessment tool to aid in patient assessment and decision making regarding safe patient handling and mobility (Arnold, 2019; VA Mobile Health, n.d.). Use of a standardized tool supports consistency and appropriate use of Safe Patient Handling and Mobility (SPHM) equipment to assist patients with the appropriate level of mobility (Arnold, 2019; Boynton et al., 2020).
• Decide which equipment to use. Protocols and algorithms are available to aid decision making to prevent injury to staff and patients.
• Plan carefully what you will do before moving or lifting a patient. Assess the mobility of attached equipment. You may injure the patient or yourself if you have not planned well. Communicate the plan with staff and the patient to ensure coordinated movement.
• Explain to the patient what you plan to do. Then, use what abilities the patient has to assist you. This technique often decreases the effort required and the possibility of injury to you.
• If the patient is in pain, administer the prescribed analgesic sufficiently in advance of the transfer to allow the patient to participate in the move comfortably.
• Elevate the bed, as necessary, so that you are working at a height that is comfortable and safe for you.
• Lock the wheels of the bed, wheelchair, or stretcher so that they do not slide while you are moving the patient.
• Be sure the patient is in good body alignment while being moved and lifted, to protect the patient from strain and muscle injury.
• Support the patient's body properly. Avoid grabbing and holding an extremity by its muscles.
• Use friction-reducing devices, whenever possible, especially during lateral transfers.
• Move your body and the patient in a smooth, rhythmic motion. Jerky movements tend to put extra strain on muscles and joints and are uncomfortable for the patient.
• Use SPHM equipment/devices when moving patients. Be sure that you understand how the device operates and that the patient is properly secured and informed of what will occur. If you are not comfortable with the operation of the equipment, obtain assistance from a caregiver who is.
• Assure equipment used meets weight requirements. Institute Bariatric Algorithms for any patient that weights more than 300 lb, or 100 lb over ideal weight, or who has a BMI over 40 (VHA CEOSH, 2015).