Risk Management - Placement 2 - 2013

 Situation – Day 3 of my gerontology placement, my supervisor is asked by a stroke physiotherapist to assist her in a treatment session with a patient. She agrees and asks if I would be interested in helping out.

Task – Assist in the transfer of a fully dependent patient from wheelchair to plinth and conduct assessment.

Action – As the patient was fully dependent, my supervisor decided that an angel transfer needed to be used to move the patient from the wheelchair to the plinth. Having transferred a few patients in a similar manner and numerous practice sessions at university I felt I was capable of doing the transfer, but having not transferred a patient in this manner for several months  (and never one that was fully dependent) it was not in the patient’s or my own best interest that I attempt this transfer, even though I was the male of the group and keen to make a good start at the placement. I made my shortcomings known and offered to be the extra pair of hands for wheelchair placement and parts management.  I observed closely as my supervisor (half my size) and the other physio planned their transfer and smoothly lifted the patient to the plinth. Their communication was clear, hand and foot placement was well positioned and the patient was fully controlled at all times. I realized how unprepared I was to be a part of this transfer having not been involved for such a long period. My risk management strategies had allowed me to recognize my deficit in this area and instead of being over-confident I took a step back. I made myself useful but not a nuisance.

Result – The patient was transferred safely and efficiently. This increased the trust that the patient has with the physiotherapist team and ultimately improve long-term treatment outcome. I handled my role safely and kept the area around the physiotherapists clear of trip hazards so that they could focus on the patient. I kept my conversation and questions to a minimum and approached my supervisor at an appropriate time to clarify a few points.

Evaluation – Although I felt I wanted to do more, I made the right call in standing back and observing how two experienced physios did it. Being a visual learner I felt I gained a great deal in seeing the set-up, the communication and the smoothness of the transfer. I did notice, however, that I although I had read through my gerontology notes and mentally rehearsed my transfers and protective behaviours, I was unprepared for a maximal assist transfer.

Strategies – Read up on the various techniques used to transfer patients and know what the patient requirements are when choosing a transfer. Practice the transfer with able bodies (other students or a helpful physio) and plan strategies to improve. Know your limitations in all aspects of physiotherapy and don’t feel inadequate when stating the limit of your knowledge. Patient safety comes first and an injured physio isn’t very useful either. Organise all notes from past placements and place them onto the Sonia server for easy access and mental revision. Use the STARES system to review all transfers to improve their effectiveness.