YOU PROBABLY HELP transfer patients every day and don't give it much thought-but you should. Performed incorrectly, these commonplace nursing actions can lead to back strain and other career-threatening injuries. In this article, I'll review safeguards and techniques for transferring a patient from bed to stretcher.

If a patient can't move independently between a bed and stretcher, gather at least three nurses to perform the transfer. (Four or five nurses may be needed to safely transfer a patient who's extremely debilitated or overweight; obese patients require a hydraulic lifter.) Obtain a transfer board (shown in the following photos) or transfer sheet to reduce the risk of injury to the patient or a nurse. Then follow these steps.

1. Lower the head of the bed so the patient is flat (unless contraindicated or not tolerated) and cover her with a sheet or blanket for privacy and warmth. Explain the procedure and assess her level of consciousness, ability to understand and follow directions, and ability to assist with the transfer. Close her door or draw the curtains for privacy and perform hand hygiene. Use personal protective equipment if indicated.Raise the level of the bed so it's slightly higher than the stretcher. Make sure the brakes are locked on both the bed and stretcher.

2. Remove the pillow from the bed and place it on the stretcher. Ask the patient to roll away from the stretcher (help her turn, if necessary). Then place the sliding board over the gap between the bed and stretcher, as shown.

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3. Help her return to a supine position on the sliding board and ask her to cross her arms on her chest.

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4. Each nurse should assume a broad base of support with one foot in front of the other and knees and hips flexed, keeping her body aligned and her back straight. On the count of three, the two nurses on the stretcher side of the bed should gently pull the sliding board toward themselves, as shown.

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5. Roll the patient to her side and remove the sliding board.

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6. Center her on the stretcher with her body in alignment. Make sure she's comfortable and raise the rails on the stretcher.

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Perform hand hygiene. Document the procedure (including the transferring technique used, the number of nurses involved, and the patient's response) according to your facility's policy.

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