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Next Reply: Re:Role of physicians in patient transfer out of bed
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Post Role of physicians in patient transfer out of bed
Author: ahmedof11
Date: Jan 28, 2012 8:47 am
I am a geriatrician responsible for educational palliative care program in the general hospital I am working in. My Palliative Care interest is that for noncancer patients. I found that patients transfer out of bed is too much neglected specially for patients prone to bedridden state like elderly, postneurosurgical, and multi-trauma cases. I believe that it is a primary responsibility of the treating physician to either help in transfering his patient himself or at least don't leave the patient during the round without ensuring the patient has been transferred by other staff. Transferring patients has many benefits whether diagnostic or therapeutic. I am not aware if there is any formal recommendations asking the physicians and specially physicians to be committed to this role? And if patient transfer is part of palliative care process that needs to be included in an educational program? Please direct me to the source of this pit of information. thanks
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Re:Role of physicians in patient transfer out of bed (by Weissman on 02/03/2012)
Hospitalized palliative care patients experience high level of functional disability which is related to multiple factors including pain, older age, mobility related impairment, disability related to the underlying disease, etc. These patients also have high fall rates. Attention to patient’s mobility status and rehabilitation needs should be part of the nursing plan of care for any patient admitted to a hospital or a long-term care facility. Early mobilization interventions and preservation of function techniques should be incorporated into the treatment plan for hospitalized patients. Physicians need to be aware of this need and should prescribe activities to promote patient’s function (e.g., out of bed to chair; assistance with transfers; trapeze to improve patient’s mobility in mobility, etc). Also, the physician should consult with Physical Therapy, Occupational Therapy and Physical Medicine and Rehabilitation for a more comprehensive assessment of patient’s disability and their rehabilitation potential. Attention to falls is essential in hospital settings as well. Fall assessment and interventions for prevention of falls should be also incorporated into the nursing plan of care. Education of healthcare providers on the benefits of rehabilitation in palliative care is essential when delivering quality patient care. Several studies documented that hospitalized palliative care patients and home hospice patients can benefit from exercise and other rehabilitative therapies. You can refer to the following review paper for more information on the principles of Rehabilitation of the Hospice and Palliative Care patient: Javier NC, Montagnini ML. Rehabilitation of the Hospice and Palliative Care Patient. Journal of Palliative Medicine 2011;14(5):638-648.

Marcos Montagnini, MD Ann Arbor VA Hospital

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