OT-FLOW-02 — Section 7: Handover and Transfers (OT Responsibilities)

7.2.1 Standard Requirement

7.2.1.1 Trolley ↔ OT table transfers shall be performed using a planned, role-assigned process to prevent patient falls, line dislodgement, pressure injury, staff musculoskeletal injury, and privacy breaches.

7.2.1.2 OT shall apply safe patient handling principles; OSHA and CDC/NIOSH provide guidance emphasizing use of assistive devices, training, and system programs to reduce injuries. (osha.gov)

7.2.2 Pre-Transfer Risk Assessment (Mandatory)

7.2.2.1 Before moving the patient, the circulating nurse confirms and documents (as applicable):

• a) mobility level (independent/assisted/immobile)
• b) weight/size considerations and need for aids
• c) fall risk indicators
• d) lines/tubes/drains present and securement status
• e) skin integrity risk (fragile skin, pressure ulcer risk)
• f) isolation precautions (PPE and equipment cleaning requirements)

7.2.2.2 Determine transfer method:

• a) manual assisted transfer (low risk only)
• b) slide sheet/transfer board
• c) mechanical lift/air-assisted device (if available and indicated)

7.2.3 Minimum Staffing and Role Assignment

7.2.3.1 Charge nurse ensures adequate trained staff are present before transfer begins.

7.2.3.2 Roles (minimum):

• a) Transfer leader (circulating nurse) — gives commands and counts down
• b) Head/airway/neck protector — protects head/neck and monitors lines at upper body
• c) Side assistants — manage trunk/legs and sheet/board
• d) Line manager (may be same as head protector) — ensures IV lines/drains/urinary catheter not pulled
• e) Equipment/brake checker — verifies brakes and alignment

7.2.4 Environment and Equipment Safety Checks (Mandatory)

7.2.4.1 Before movement:

• a) clear floor of obstacles; ensure adequate space
• b) confirm privacy coverage
• c) ensure adequate lighting
• d) confirm OT table height and trolley height alignment as much as possible
• e) apply brakes on trolley and OT table
• f) verify side rails as appropriate (down only when actively transferring and controlled)

7.2.4.2 Infection prevention: use clean transfer aids, and follow cleaning rules for reusable devices per IPC policy.

7.2.5 Transfer Techniques (Standard Methods)

7.2.5.1 Slide Sheet / Transfer Board Method (Preferred for Moderate Risk)

• a) place slide sheet under patient per technique
• b) align surfaces and secure brakes
• c) leader instructs “Ready—1,2,3 move”
• d) move in one coordinated action (avoid twisting)
• e) remove/adjust sheet carefully while maintaining patient warmth and dignity

7.2.5.2 Mechanical Lift Method (Preferred for High Risk When Available)

• a) apply sling per training
• b) lift and position with controlled movement
• c) maintain patient comfort and privacy
• d) lower and position patient; remove sling as appropriate

OSHA safe patient handling resources highlight equipment use as essential for reducing manual lifting injuries and improving patient care quality. (osha.gov)

7.2.5.3 Manual Lift (Restricted Use)

• a) manual lifting should be minimized; use only when patient is low weight/low risk and equipment is not required by policy
• b) do not perform high-risk manual lifts that endanger staff or patient
• c) if insufficient staff/equipment exists, transfer is delayed until safe controls are available

7.2.6 Protection of Lines, Tubes, Drains, and Devices

7.2.6.1 The line manager confirms:

• a) IV lines not under tension; pumps and poles positioned safely
• b) urinary catheter secured and bag positioned below bladder without pulling
• c) drains secured and not caught
• d) oxygen tubing (if in use per order) is long enough and not kinked

7.2.6.2 Any dislodgement or suspected device issue is documented and reported.

7.2.7 Patient Safety and Comfort Controls

7.2.7.1 Positioning after transfer:

• a) align patient midline; protect pressure points
• b) ensure warming measures per OT practice
• c) secure patient with safety strap when appropriate

7.2.7.2 Falls prevention: never leave patient unattended on trolley or table without rails/strap as appropriate and staff presence.

7.2.8 Incident and Near-Miss Management

7.2.8.1 The following require immediate reporting and review:

• a) patient fall or near fall during transfer
• b) line dislodgement or near dislodgement
• c) staff injury
• d) repeated unsafe conditions (lack of transfer aids, inadequate staff)

Reporting supports system improvement and safety program monitoring (linked to SEC 3 OT QPS).

7.2.9 Documentation

• 7.2.9.1 OT documents transfer method, staff involved, and any issues.
• 7.2.9.2 For high-risk transfers, complete a transfer checklist (Appendix B).