M14 · Unsafe wheelchair or transfer
Actual Movement and self-care
Definition
Moving between bed, chair, and toilet is unsafe for the person or the helper.- Weak legs
- heavy patient
- poor technique
- no equipment
- Near falls during transfer
- pain in the helper's back
📋 Scenario
A nurse transfers a heavy patient alone and strains her back.
Subjective (S): "I'm afraid I'll fall when you move me."
Objective (O): Heavy patient; nurse transferred alone and strained her back; patient grips tightly; near fall.
Assessment tools for this scenario: CP-MOVE Movement & Self-Care Score CP-SAFE Safety & Falls Score
Validated scales to consider: Barthel Index, Katz ADL, Morse Fall Scale
**CarePath diagnosis:** Unsafe wheelchair or transfer related to weak legs, as evidenced by near falls during transfer and pain in the helper's back.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Use hoists or slide sheets. | Hoists and slide sheets take the load off the nurse and move the patient smoothly, which lowers the risk of back injury and dropping her. |
| Use two staff when needed. | A heavy patient is too much for one person, and a second staff member shares the load and helps keep her stable. |
| Lock wheels. | Locked wheels stop the chair rolling away during transfer, which is a common cause of falls. |
| Teach safe transfer. | Correct technique protects the nurse's back and keeps the patient steady, so she feels safe and cooperates. |
| Assess ability first. | Assessment shows how much she can do herself and which equipment and how many staff are needed, so the right method is chosen. |
**Expected outcomes**
- All transfers done with equipment and two staff.
- No falls or injuries.
- Patient says she feels safe.
**Linking the data to the diagnosis**
A patient says, "I'm afraid I'll fall when you move me." She is heavy, the nurse transferred her alone and strained her back, the patient gripped tightly and there was a near fall. The unsafe transfer has already happened and injured a helper, so an actual statement fits. The plan aims to make every transfer safe by using equipment and two staff, locking wheels and assessing first. The expected outcomes are all transfers with equipment and two staff, no falls or injuries and the patient saying she feels safe.
CarePath diagnosis
Unsafe wheelchair or transfer related to weak legs, as evidenced by near falls during transfer and pain in the helper's back.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Use hoists or slide sheets. | Hoists and slide sheets take the load off the nurse and move the patient smoothly, which lowers the risk of back injury and dropping her. |
| 2. Use two staff when needed. | A heavy patient is too much for one person, and a second staff member shares the load and helps keep her stable. |
| 3. Lock wheels. | Locked wheels stop the chair rolling away during transfer, which is a common cause of falls. |
| 4. Teach safe transfer. | Correct technique protects the nurse's back and keeps the patient steady, so she feels safe and cooperates. |
| 5. Assess ability first. | Assessment shows how much she can do herself and which equipment and how many staff are needed, so the right method is chosen. |
Expected outcomes
- All transfers done with equipment and two staff.
- No falls or injuries.
- Patient says she feels safe.
Linking the data to the diagnosis
A patient says, "I'm afraid I'll fall when you move me." She is heavy, the nurse transferred her alone and strained her back, the patient gripped tightly and there was a near fall. The unsafe transfer has already happened and injured a helper, so an actual statement fits. The plan aims to make every transfer safe by using equipment and two staff, locking wheels and assessing first. The expected outcomes are all transfers with equipment and two staff, no falls or injuries and the patient saying she feels safe.