Transfer and Positioning Care Plan

Transfer and positioning care plan

for education, child/care and community support services*

CONFIDENTIAL

To be completed by the PHYSIOTHERAPIST or other relevant health professional, and the PARENT/GUARDIAN
and/or ADULT STUDENT/CLIENT for a person who requires individual health and personal care support.
This information is confidential and will be available only to supervising staff and emergency medical personnel.

Name of child/student/client Date of birth

Family name (please print) First name (please print)

MedicAlert Number (if relevant) Date for review

Staff are required to meet duty of care and occupational health and safety obligations. In relation to transfers and positioning, this means they will:

§  Minimise the number of transfers and other positioning undertaken in the course of their work – to minimise work-related harm – while ensuring that child/student/client safety, comfort and curriculum access is maximised.

§  Use the following care recommendations to negotiate and document, with the family/client, a worksite health support plan detailing how transfers and positioning support will be provided.

§  Generally select the transfer/positioning procedure, as documented below, which minimises the time required to provide support. If additional time is required to develop child/student/client independence, this will need to be negotiated with the staff.

Situation and level of assistance required / Type of transfer / Equipment
CHAIR TO CHAIR
(eg wheelchair to chair/commode)
Independent
Standby assistance required (for occasional interventions to support safety)
Cooperative assistance
Indicate whether one, two or three adults to assist
Dependent
Indicate whether one, two or three adults to assist / Top and tail
Cradle
Side to side
Standing transfer
Other
Mechanical / Hoist
Sling (specify below)
Side board
Transfer plate/disc
Other (specify below)
Comment (eg in relation to communication, safety, comfort, dignity and learning)
ëAttachments Yes No
CHAIR TO GROUND/FLOOR
Independent
Standby assistance required (for occasional interventions to support safety)
Cooperative assistance
Indicate whether one, two or three adults to assist
Dependent
Indicate whether one, two or three adults to assist / Top and tail
Cradle
Side to side
Standing transfer
Other
Mechanical / Hoist
Sling (specify below)
Side board
Transfer plate/disc
Other (specify below)
Comment (eg in relation to communication, safety, comfort, dignity and learning)
ëAttachments Yes No

DECD 2015 1 of 5

Transfer and positioning care plan (cont)

Situation and level of assistance required / Type of transfer / Equipment
GROUND/FLOOR TO CHAIR
Independent
Standby assistance required (for occasional interventions to support safety)
Cooperative assistance
Indicate whether one, two or three adults to assist
Dependent
Indicate whether one, two or three adults to assist / Top and tail
Cradle
Side to side
Standing transfer
Other
Mechanical / Hoist
Sling (specify below)
Side board
Transfer plate/disc
Other (specify below)
Comment (eg in relation to communication, safety, comfort, dignity and learning)
ëAttachments Yes No
CHAIR TO CHANGE TABLE
Independent
Standby assistance required (for occasional interventions to support safety)
Cooperative assistance
Indicate whether one, two or three adults to assist
Dependent
Indicate whether one, two or three adults to assist / Top and tail
Cradle
Side to side
Standing transfer
Other
Mechanical / Hoist
Sling (specify below)
Side board
Transfer plate/disc
Other (specify below)
Comment (eg in relation to communication, safety, comfort, dignity and learning)
ëAttachments Yes No
TOILETING TRANSFER
Independent
Standby assistance required (for occasional interventions to support safety)
Cooperative assistance
Indicate whether one, two or three adults to assist
Dependent
Indicate whether one, two or three adults to assist / Top and tail
Cradle
Side to side
Standing transfer
Other
Mechanical / Hoist
Sling (specify below)
Side board
Transfer plate/disc
Other (specify below)
Comment (eg in relation to communication, safety, comfort, dignity and learning)
ëAttachments Yes No

DECD 2015 1 of 5

Transfer and positioning care plan (cont)

Situation and level of assistance required / Type of transfer / Equipment
VEHICLE TO CHAIR
Independent
Standby assistance required (for occasional interventions to support safety)
Cooperative assistance
Indicate whether one, two or three adults to assist
Dependent
Indicate whether one, two or three adults to assist / Top and tail
Cradle
Side to side
Standing transfer
Other
Mechanical / Hoist
Sling (specify below)
Side board
Transfer plate/disc
Other (specify below)
Comment (eg in relation to communication, safety, comfort, dignity and learning)
ëAttachments Yes No
Situation / Comment
MOBILITY INDOORS
(eg use of sticks, stairs, steps, negotiation of furniture, varying floor coverings)
MOBILITY OUTDOORS
SPECIAL EQUIPMENT
(eg wedge, standing frames)
OTHER
(eg information related to additional repositioning)

General supervision for safety

Staff members will routinely talk the child/student/client through the transfer or positioning, seeking his or her permission to the degree possible and maximising cooperation.

DECD 2015 1 of 5

Transfer and positioning care plan (cont)

Communication by support worker

Simplify instructions/use key words

Use picture cues

Other

Communication by child/student/client

Language

Gesture

Behaviour

Other

DECD 2015 1 of 5

Transfer and positioning care plan (cont)

Learning targets: specific strategies and assistance

Increasing independence (eg take some weight on arms, transfer without assistance)

Behaviour targets (eg comply with transfer)

Communication (eg indicate preferred side for lift, indicate comfort)

Other (please specify)

DECD 2015 1 of 5

Transfer and positioning care plan (cont)

Documentation

Staff can be requested to document observations to assist review of this plan.

Complete attached proformas

Other (please specify)

Additional information attached to this care plan

Further information regarding transfers/positioning for this person

Risk assessment information

Safe use of harness

General information about this person’s care needs

Transfer and positioning log

Other (please specify)

Recommended training for carers undertaking this TPCP

General manual handling training (arranged through employer as part of the OHS&W requirements)

General Transfer and Position Support Training

OR

§  Novita Children’s Services can provide general transfer and positioning training on a fee-for-service basis (direct enquiries to Novita phone: : 1300 668 482)

1:1 training support person(s)

1:1 training with child/student and support person(s)

Other (please specify)

*This plan has been developed for the following services/settings:

School/education Outings/camps/holidays/aquatics

Child/care Work

Respite/accommodation Home

Transport Other (please specify)

AUTHORISATION AND RELEASE

Health professional Professional role

Name of agency/address

Telephone

Signature Date

I have read, understood and agreed with this plan and any attachments indicated above.

I approve the release of this information to supervising staff and emergency medical personnel.

Parent/guardian

or adult student/client Signature Date

Family name (please print) First name (please print)

DECD 2015 1 of 5

Transfer and positioning care plan (cont)

Hydrotherapy/pool information

This page can be sent as a separate document to the hydrotherapy or pool facility for staff to use. It must be attached to a copy of the first page of Transfer and positioning care plan.

Name of child/student/client Date of birth

Family name (please print) First name (please print)

MedicAlert Number (if relevant) Date for review

CHAIR TO
Independent
Standby assistance required (for occasional interventions to support safety)
Cooperative assistance
Indicate whether one, two or three adults to assist
Dependent
Indicate whether one, two or three adults to assist / Top and tail
Cradle
Side to side
Standing transfer
Other
Mechanical / Hoist
Sling (specify below)
Slide board
Transfer plate/disc
Other (specify below)
Comment/assessment summary
ëAttachments Yes No
TRANSFER INTO POOL
Independent
Standby assistance required (for occasional interventions to support safety)
Cooperative assistance
Indicate whether one, two or three adults to assist
Dependent
Indicate whether one, two or three adults to assist / Top and tail
Cradle
Side to side
Standing transfer
Other
Mechanical / Hoist
Sling (specify below)
Slide board
Transfer plate/disc
Other (specify below)
Comment/assessment summary
ëAttachments Yes No
TRANSFER OUT OF POOL
Independent
Standby assistance required (for occasional interventions to support safety)
Cooperative assistance
Indicate whether one, two or three adults to assist
Dependent
Indicate whether one, two or three adults to assist / Top and tail
Cradle
Side to side
Standing transfer
Other
Mechanical / Hoist
Sling (specify below)
Slide board
Transfer plate/disc
Other (specify below)
Comment/assessment summary
ëAttachments Yes No

AUTHORISATION AND RELEASE

Health professional Professional role

Name of agency/address

Telephone

Signature Date

I have read, understood and agreed with this plan and any attachments indicated above.

I approve the release of this information to supervising staff and emergency medical personnel.

Parent/guardian

or adult student/client Signature Date

Family name (please print) First name (please print)

DECD 2015 1 of 5