What is the correct initial step when transferring a resident from bed to a wheelchair using a transfer belt?

• A. Wheelchair lock on side of bed w/footrests up; Sit patient up; Shoes on + feet flat on floor; Apply transfer belt; Bend knees, feet apart one leg between + upward grasp
• B. Sit patient up; Wheelchair lock on side of bed w/footrests up; Shoes on + feet flat on floor; Apply transfer belt; Bend knees, feet apart one leg between + upward grasp
• C. Wheelchair lock on side of bed w/footrests up; Shoes on + feet flat on floor; Apply transfer belt; Sit patient up; Bend knees, feet apart one leg between + upward grasp
• D. Sit patient up; Apply transfer belt; Wheelchair lock on side of bed w/footrests up; Shoes on + feet flat on floor

Answer: (A)

Securing the environment and patient before starting the transfer is the key. Locking the wheelchair first prevents it from rolling during the move, and lifting the footrests up creates a clear, unobstructed path for the transfer. Once the chair is stabilized, sitting the resident up gives them a stable, upright position to begin the transfer and helps align their center of gravity. Having shoes on and feet flat on the floor provides a solid base so they won’t slip when you support or assist them.

Applying the transfer belt after the resident is seated gives you a secure grip to guide the transfer without pulling on the arms, and it helps you control the motion safely. Good body mechanics—bending the knees, keeping feet apart, and placing one leg between the resident’s legs while you grip the belt with an upward, close-to-your-body hold—maximizes balance and protects your back.

Starting with seating them up or applying the belt before securing the chair can allow movement or instability during the transfer, which increases risk. The sequence in this option follows safe transfer practice by first stabilizing the environment, then positioning the resident, then applying the belt, and finally using proper stance to perform the transfer.