Introduction
Patients are required to transfer to new patient care units and new agencies to receive different forms and levels of therapy and services. Continuity of care becomes essential at these situations.
Definition
Transfer refers to the shifting of patients from one ward to another ward or within department or to another hospital.
Purposes
- To continue health care so as to avoid therapeutic interruptions that may hinder progress toward recovery.
- For appropriate utilization of available resources and personnel.
Articles
Preparation of Equipment
- Transfer forms.
- Copies of medical records, radiology films, laboratory test results, etc.
- Special equipment as needed.
- Wheelchair or stretcher.
- Emesis basin.
- Bed pan and/or urinal.
- Oxygen cylinder and tubing, IV pole, cardiac monitor.
- Emergency medications.
Procedure
| Nursing actions | Rationale | |
| 1. | Check the doctor’s order for transfer to another ward, department, or hospital. | To plan the care. |
| 2. | Inform the patient and relatives regarding the transfer of the patient. | Enhances cooperation. |
| 3. | Inform the nurse-in-charge of the interdepartment or ward or hospital regarding transferring the patient. Explain also the brief details of the patient including name, age, diagnosis, current health status, and reason for transfer, and other important doctor’s orders to be followed. | Helps the other team to be prepared in advance. |
| 4. | Complete all the nursing care and administer the medications as per order. | To avoid duplication of care. |
| 5. | Make sure that the needed documentation is complete in the patient’s record. | Accurate information is necessary for the receiving institution or ward to provide care. |
| 6. | Complete the transfer form according to institutional policy. | It provides summary of patient care. |
| 7. | Ensure that the bills of the patient have been settled. | To prevent loss to the hospital. |
| 8. | Gather the patient’s personal care items, clothing and valuables, and necessary reports, and check the entire room. | Prevents the loss of articles during transfer. |
| 9. | Anticipate patient’s problems during transfer. | Ensures patient’s safety. |
| 10. | Assist in transferring the patient to stretcher or wheelchair using safe patient handling techniques. | For safe and easy transfer. |
| 11. | Ensure that the unit is cleaned and ready. | For the next patient. |
Special Considerations
- Risk-Benefit Analysis: Weigh the necessity of transfer against potential risks—avoid unnecessary movement if possible.
- Documentation: Record vital signs, NEWS scores, reason for transfer, and names of coordinating personnel.
- Communication: Ensure clear handover between sending and receiving teams, including consultant-to-consultant agreement for critical cases.
- Appropriate Transport Mode: Choose based on acuity—ambulance with life support for critical patients, wheelchair or stretcher for stable ones.
- Equipment Check: Verify functionality of stretchers, oxygen supply, monitors, and emergency gear.
- Assistive Devices: Use transfer belts, sliding boards, or mechanical lifts to reduce strain and injury.
- Trained Personnel: Ensure escort staff are competent in managing the patient’s condition during transfer.
- Team Coordination: Assign clear roles and use a designated leader to coordinate movement steps.
- Patient Engagement: Explain the process, address concerns, and maintain privacy and dignity throughout.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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