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Moving Patients from Bed to Chair or Wheelchair

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By Gil Wayne BSN, R.N.

Transferring patients from a bed to a chair or wheelchair is a crucial nursing skill that demands physical strength and precise technique. Mastering this task ensures patient safety and comfort, prevents injuries, and enhances patient independence. Key best practices include understanding body mechanics, assessing the patient, and using assistive devices. By focusing on these principles, nurses can efficiently and compassionately provide optimal care during transfers.

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Transferring Patients from Bed to Chair or Wheelchair

Mobility is a fundamental aspect of patient care in nursing, crucial for both physical health and psychological well-being. Ensuring that patients can move safely and comfortably from one location to another, such as from a bed to a chair or wheelchair, is vital. Mobility enhances circulation, reduces the risk of pressure ulcers, and prevents the complications associated with prolonged immobility. Moreover, it fosters a sense of independence and boosts the patient’s confidence and overall quality of life. The ability to transfer patients safely and effectively is a critical skill that nurses must master to provide comprehensive care.

Moving patients from a bed to a chair or wheelchair involves more than just physical effort; it requires a deep understanding of proper body mechanics, the use of assistive devices, and patient assessment. Nurses must evaluate the patient’s physical capabilities, medical condition, and any potential risks before attempting a transfer. This assessment helps in choosing the right technique and equipment, ensuring the safety of both the patient and the nurse. Additionally, clear communication with the patient during the transfer process is essential to provide reassurance and instructions, minimizing anxiety and enhancing cooperation.

Effective patient transfers are also integral to preventing injuries. Improper techniques can lead to falls, strains, and other injuries for both patients and healthcare providers. Therefore, nurses are trained to use specific methods and tools, such as transfer belts, slide boards, and mechanical lifts, to facilitate safe and smooth transfers. These tools, combined with proper training, help nurses maintain the patient’s dignity and comfort while ensuring their own safety. By adhering to best practices and continuously honing their skills, nurses can significantly improve patient outcomes and contribute to a safer healthcare environment.

Purpose of Transferring Patients from Bed to Chair or Wheelchair

Transferring patients from a bed to a chair or wheelchair serves several essential purposes in nursing care. These transfers are important for practical reasons including:

1. To Strengthen the Patient Gradually

Regular movement and transferring help maintain muscle tone and joint flexibility. Gradual strengthening through these transfers can enhance the patient’s ability to perform more activities independently over time, contributing to a quicker and more effective recovery process.

2. To Provide a Change in Position

Remaining in one position for extended periods can lead to complications such as pressure ulcers, muscle stiffness, and decreased circulation. Changing positions helps in distributing pressure more evenly across different parts of the body, preventing pressure-related injuries and improving overall circulation.

3. To Promote Patient Mobility

Mobility is crucial for preventing complications associated with prolonged immobility, such as deep vein thrombosis and muscle atrophy. Promoting mobility through transfers helps maintain and improve the patient’s physical health, ensuring that muscles and joints remain active and functional.

4. To Enhance Psychological Well-being

The ability to move freely from bed to chair or wheelchair fosters a sense of independence and autonomy, significantly enhancing a patient’s mood and outlook on their recovery process. It also reduces feelings of isolation and helplessness, promoting a more positive mental state.

5. To Facilitate Access to Services and Activities

Transferring patients to a chair or wheelchair enables them to access various services and participate in essential activities such as physical therapy, dining, and recreational activities. These activities are often conducted outside the confines of a bed, making transfers crucial for comprehensive care.

6. To Support Hygiene and Personal Care

Effective transfers are vital for hygiene and personal care routines, allowing patients to use bathroom facilities with greater ease and facilitating more thorough cleaning during bed changes. This helps maintain the patient’s cleanliness and dignity.

7. To Improve Comfort

Regular transfers help in relieving discomfort associated with staying in one position for too long. Providing opportunities for patients to sit up in a chair or move to a wheelchair can enhance their overall comfort and contribute to a better quality of life.

Equipment Used in Transferring Patients

The following list includes essential items that help facilitate a smooth and secure transfer, minimizing the risk of injury for both patients, nurses, and caregivers.

1. Chair or Wheelchair. A stable chair or a wheelchair with locks and removable armrests (if possible). Provides a secure and comfortable place for the patient to sit. The wheelchair allows for greater mobility and access to different areas within the healthcare facility or home.

2. Patient’s Robe and Slippers. Comfortable clothing that is easy to put on and take off, along with non-slip slippers. Ensures the patient remains warm and comfortable during the transfer, and the non-slip slippers help prevent falls.

3. Pillows. Soft, supportive cushions. Used to provide additional support and comfort during the transfer process. Pillows can be placed in strategic positions to support the patient’s back or sides as needed.

4. Blanket, Sheet, or Draw Sheet. A clean blanket, sheet, or a specialized draw sheet. Used to cover the patient during the transfer, maintaining privacy and warmth. A draw sheet can also be used to assist with lifting and repositioning the patient safely.

5. Transfer Belt (Gait Belt). A sturdy belt that is secured around the patient’s waist. Provides caregivers with a secure hold to assist in lifting and guiding the patient during the transfer. It helps in reducing the risk of injury to both the patient and the caregiver.

6. Slide Board (Transfer Board). A smooth, flat board made of plastic or wood. Facilitates the transfer of patients who can partially bear weight but need additional support. The slide board helps in moving the patient smoothly from bed to chair or wheelchair without lifting.

7. Mechanical Lift. A hydraulic or electric lift with a sling. Used for patients who are unable to assist with the transfer. The mechanical lift safely supports and moves the patient from bed to chair or wheelchair, minimizing the risk of injury.

8. Footstool or Step Stool. A sturdy, non-slip stool. Assists patients in stepping down safely from the bed to the floor or chair. It can help patients who need a little extra height to transition smoothly.

9. Non-slip Mats. Mats with a non-slip surface. Placed beside the bed and around the chair or wheelchair to prevent slipping and provide a secure footing during transfers.

10. Grab Bars or Handrails. Fixed bars attached to walls or furniture. Provide additional support and stability for patients to hold onto during the transfer process, reducing the risk of falls.


This list of precautions highlights specific circumstances in which transferring patients may pose risks to their health or exacerbate underlying medical conditions. By recognizing and adhering to these precautions, healthcare providers can effectively mitigate potential complications and provide appropriate care tailored to each patient’s individual needs.

1. Unstable Vital Signs. If a patient exhibits unstable vital signs such as low blood pressure, high heart rate, or irregular breathing patterns, transferring them to a chair or wheelchair may exacerbate their condition and pose a risk to their health.

2. Recent Surgical Procedures. Patients who have undergone recent surgical procedures, particularly those involving the abdomen, spine, or lower extremities, may have restrictions on movement and require bed rest to facilitate healing and prevent complications.

3. Presence of Medical Devices. Patients with medical devices such as intravenous lines, catheters, or wound dressings may experience discomfort or dislodgement of these devices during transfer, necessitating caution and evaluation by healthcare providers before attempting to move them.

4. Musculoskeletal Injuries. Patients with musculoskeletal injuries, fractures, or sprains may experience pain or further damage if transferred improperly or without appropriate support, necessitating immobilization and evaluation by a healthcare professional before any movement.

5. Cognitive Impairment. Patients with cognitive impairment, confusion, or disorientation may be at risk of falls or injury during transfers if they are unable to understand or follow instructions, requiring close supervision and specialized assistance from trained caregivers.

6. Acute Medical Conditions. Patients experiencing acute medical conditions such as acute myocardial infarction, stroke, or respiratory distress may require immediate medical attention and interventions, making transfer to a chair or wheelchair inappropriate until their condition stabilizes.

7. Uncontrolled Pain. Patients experiencing severe or uncontrolled pain may have limited mobility and tolerance for movement, requiring careful assessment and management of pain before considering transfer to a chair or wheelchair.

8. Risk of Falls. Patients identified as high risk for falls due to factors such as impaired balance, weakness, or history of falls should not be transferred to a chair or wheelchair without appropriate safety measures in place to prevent accidents.

Procedures in Transferring Patients from Bed to Chair or Wheelchair

These following procedures involve a series of systematic steps designed to safely move patients from one surface to another, considering their physical condition and the environment.

1. See that the chair or wheelchair is in good condition.
Ensuring the chair or wheelchair is in good condition prevents mechanical failures during the transfer, which could cause injury.

2. Place the chair conveniently at right angles to the bed—the back of the chair parallel to the foot of the bed and facing the head of the bed.
Positioning the chair this way makes the transfer easier and safer by minimizing the distance the patient has to move and providing stable support.

3. Place a pillow on the seat of the chair. If using a wheelchair, line it with a blanket or sheet and arrange pillows on the seat and against the back. Put the footrests up and lock the wheels.
Providing cushioning and securing the chair or wheelchair enhances patient comfort and stability during the transfer.

4. Take the patient’s pulse.
Checking the patient’s pulse before the transfer helps monitor their baseline vital signs and assess their readiness for movement.

5. Assist the patient to a sitting position on the bed by putting one arm under their head and shoulders and the other arm under their knees. Pivot them to a sitting position with legs hanging over the side of the bed.
This method supports the patient’s body and prevents strain or injury while moving them to a sitting position.

6. Watch the patient for a minute to detect any change in their color, pulse, and respiratory rate.
Observing the patient allows you to identify any signs of distress or instability before proceeding with the transfer.

7. Put on the patient’s robe and slippers. Place the footstool under the patient’s feet.
Ensuring the patient is appropriately dressed and has support for their feet helps maintain their comfort and stability.

8. Stand directly in front of the patient and with a hand under each axilla, assist them to stand, step down, and turn around with their back to the chair. Let the patient flex their knees and lower their body to sit in the chair. Anchor the chair with your foot or have someone hold it. Alternatively, let the patient place their arm over your shoulders while you put your arm around their waist. Turn the patient around with their back to the chair and seat them gently.
This technique provides maximum support and stability, reducing the risk of falls or injuries during the transfer.

9. Adjust the pillows and wrap a blanket over the patient’s lap. If in a wheelchair, adjust the footrests.
Ensuring the patient is comfortable and properly positioned in the chair or wheelchair helps prevent discomfort and potential pressure sores.

10. Observe frequently for changes in color and pulse rate, dizziness, or signs of fatigue.
Continuous monitoring allows for early detection of any adverse reactions to the transfer, enabling prompt intervention if necessary.

11. To put the patient back to bed, assist them to stand, help them turn, and stand on the stool, and guide them back to bed. Support the patient while they sit on the side of the bed. Remove the robe and slippers. Pivot them to a sitting position in bed, supporting their head and shoulders with one arm and their knees with the other arm, and lower them slowly to a lying position.
Providing support and guiding the patient through the steps ensures their safety and comfort during the return transfer.

12. Draw up the bedding.
Properly arranging the bedding ensures the patient’s comfort and prevents entanglement.

13. Take the patient’s pulse after the transfer.
Checking the pulse again helps assess the patient’s response to the transfer and ensures they are stable.

14. Document the transfer.
Accurate documentation provides a record of the care provided and any observations, which is essential for ongoing patient care and communication among healthcare providers.


  • Garg, A., Owen, B., Beller, D., & Banaag, J. (1991). A biomechanical and ergonomic evaluation of patient transferring tasks: Bed to wheelchair and wheelchair to bed. Ergonomics, 34(3), 289-312.
  • Berman, A., Snyder, S. J., & Frandsen, G. (2015). Kozier & Erb’s fundamentals of nursing: Concepts, process, and practice (10th ed.). Pearson.

Gil Wayne ignites the minds of future nurses through his work as a part-time nurse instructor, writer, and contributor for Nurseslabs, striving to inspire the next generation to reach their full potential and elevate the nursing profession.

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