3 Mobility and Safe Patient Handling
Learn how to assess patients and the environment, support safe movement and range of motion, use mobility aids, and reduce risks associated with immobility.
Why and safe handling matter
supports independence and helps prevent complications of bed rest. Safe movement also protects the patient and caregiver.
Follow the patient’s care plan, activity orders, facility procedures, and instructions from the nurse or physical therapist. Do not attempt a transfer if the patient’s needs exceed your training or the assistance available.
Assess and prepare before movement
Before repositioning, transferring, or walking with a patient, check the care plan and consider the patient’s alertness, ability to follow directions, balance, strength, weight-bearing ability, pain, dizziness, and usual . Note relevant restrictions, including those related to recent surgery, injury, or movement precautions. Check for tubing, drains, and other equipment that could be pulled or caught.
Explain the activity and obtain the patient’s cooperation. Let the patient do as much as is safe. Prepare the route and destination by clearing clutter, positioning the chair or aid, and ensuring the patient has nonskid footwear. Lock the bed and wheelchair before a transfer. Raise the bed to a suitable working height for care, then lower it as appropriate afterward.
If the patient becomes faint, unusually weak, short of breath, or distressed, stop the activity and get help.
Handle transfers and positioning safely
Use an approved handling method and equipment appropriate to the patient’s assessed needs. Minimize manual lifting; relying on “good body mechanics” alone does not make lifting a patient safe. Mechanical lifts, standing-assist devices, slide boards, and friction-reducing sheets serve different purposes. Select and use equipment according to the patient’s abilities, equipment instructions, and staff training.
A standing-assist device requires the patient to meet its weight-bearing and cooperation criteria. Use a full-body lift when the patient cannot safely support their weight. A can help stabilize some ambulatory patients, but it is not a lifting device.
For a transfer, use the prescribed number of helpers and the appropriate device. Coordinate the movement with a clear count or cue, encourage the patient to participate, and avoid twisting or pulling on the patient’s arms. Never try to catch or lift a falling patient alone; follow facility procedures and summon help.
Position the patient with the body aligned and limbs comfortably supported. Reposition patients who cannot move independently according to their individualized care plan, skin condition, comfort, and support surface. Check skin and comfort during care, and avoid dragging because it can cause friction and shear. There is no single turning schedule that is suitable for everyone.
Support range of motion
Range-of-motion (ROM) exercises move joints through their available motion. In , the patient moves independently; in , a caregiver gently moves a limb when the patient cannot do so.
Perform exercises only as prescribed or taught, and follow movement restrictions. Support the limb and move slowly and smoothly. Stop if the patient reports pain or you feel resistance; never force a joint. Encourage active participation when safe, and involve the nurse or therapist if movement is painful, restricted, or unfamiliar.
Use aids appropriately
Common aids include canes, walkers, crutches, wheelchairs, and mechanical lifts. Use only the aid recommended for the patient, make sure it is in good condition and properly fitted, and follow the training provided for its use.
Keep a walker or cane within safe reach when the patient is seated, but do not let the patient pull on it to stand unless specifically instructed. Before walking, confirm the patient’s permitted activity level, secure needed lines, and provide the supervision specified in the care plan. Use a wheelchair when walking is not safe or permitted, and lock its wheels for transfers.
Reduce the risks of
Prolonged can contribute to muscle weakness and loss of function, joint stiffness, pressure injury, constipation, urinary problems, blood clots, and respiratory complications.
Reduce avoidable bed rest by supporting safe, progressive activity as permitted by the patient’s condition and plan. This may include repositioning, sitting up, standing, walking, and taking part in daily activities. Encourage prescribed range-of-motion exercises and exercise, protect skin through individualized repositioning and skin checks, and support hydration, nutrition, and breathing exercises when appropriate.
Report new pain, swelling, redness, weakness, or reduced ability to move.