Impaired transfer ability is a nursing diagnosis that refers to a limitation in independent movement between two nearby surfaces, such as moving from bed to chair or chair to toilet. This condition requires comprehensive nursing assessment and intervention to promote patient safety, independence, and quality of life.
Causes (Related to)
Impaired transfer ability can result from various factors affecting a patient’s mobility and strength:
- Physical conditions such as:
- Musculoskeletal disorders
- Neurological conditions
- Post-surgical states
- Obesity
- Arthritis
- Recent trauma or injury
- Cognitive factors include:
- Confusion
- Dementia
- Impaired judgment
- Decreased level of consciousness
- Environmental factors such as:
- Inappropriate assistive devices
- Unsafe furniture height
- Limited space
- Poor lighting
- Slippery surfaces
Signs and Symptoms (As evidenced by)
Accurate identification of signs and symptoms is crucial for proper diagnosis and treatment planning.
Subjective: (Patient reports)
- Fear of falling
- Pain during movement
- Decreased confidence in mobility
- Feeling of weakness
- Dizziness during position changes
- Anxiety about moving
Objective: (Nurse assesses)
- Inability to transfer between surfaces safely
- Required assistance for transfers
- Impaired balance
- Decreased muscle strength
- Unstable positioning
- Use of assistive devices
- Limited range of motion
- Poor coordination
Expected Outcomes
Successful management of impaired transfer ability includes:
- The patient will demonstrate safe transfer techniques
- The patient will maintain an optimal level of independence
- The patient will use assistive devices correctly
- The patient will avoid falls or injuries during transfers
- The patient will show improved confidence in mobility
- The patient will maintain skin integrity
- Caregiver will demonstrate proper transfer assistance techniques
Nursing Assessment
Evaluate Physical Capabilities
- Assess muscle strength
- Check the range of motion
- Evaluate balance and coordination
- Monitor vital signs during activity
- Assess pain levels
Review Risk Factors
- Document underlying conditions
- Assess cognitive status
- Review medication effects
- Check nutritional status
- Evaluate fatigue levels
Assess Environmental Safety
- Check furniture stability
- Evaluate surface heights
- Assess space availability
- Review lighting conditions
- Inspect floor surfaces
Evaluate Support Systems
- Assess caregiver availability
- Check appropriate assistive devices
- Review home environment
- Document social support
- Evaluate financial resources
Monitor Progress
- Track transfer ability improvements
- Document assistance level needed
- Assess confidence levels
- Review safety awareness
- Monitor complications
Nursing Care Plans
Nursing Care Plan 1: Risk for Falls
Nursing Diagnosis Statement:
Risk for Falls related to impaired transfer ability as evidenced by unsteady gait and required assistance during transfers.
Related Factors:
- Decreased muscle strength
- Balance impairment
- Environmental hazards
- Medication effects
Nursing Interventions and Rationales:
- Implement fall precautions
Rationale: Prevents injury and promotes safety - Assess transfer ability regularly
Rationale: Identifies changes in status and needed interventions - Provide appropriate assistive devices
Rationale: Supports safe transfers and independence
Desired Outcomes:
- The patient will transfer safely without falls
- The patient will demonstrate proper use of assistive devices
- The patient will maintain safety awareness during transfers
Nursing Care Plan 2: Impaired Physical Mobility
Nursing Diagnosis Statement:
Impaired Physical Mobility related to neuromuscular impairment as evidenced by difficulty with transfers and limited movement.
Related Factors:
- Muscle weakness
- Joint stiffness
- Pain
- Decreased endurance
Nursing Interventions and Rationales:
- Provide progressive mobility exercises
Rationale: Improves strength and endurance - Teach proper body mechanics
Rationale: Promotes safe movement techniques - Schedule regular rest periods
Rationale: Prevents fatigue and injury
Desired Outcomes:
- The patient will demonstrate improved strength
- The patient will perform transfers with minimal assistance
- The patient will maintain the optimal activity level
Nursing Care Plan 3: Risk for Impaired Skin Integrity
Nursing Diagnosis Statement:
Risk for Impaired Skin Integrity related to friction during transfers as evidenced by vulnerable skin condition.
Related Factors:
- Pressure during transfers
- Shearing forces
- Poor nutrition
- Decreased mobility
Nursing Interventions and Rationales:
- Assess skin condition regularly
Rationale: Identifies early signs of breakdown - Use proper transfer techniques
Rationale: Minimizes friction and shearing - Maintain proper nutrition
Rationale: Supports skin health
Desired Outcomes:
- The patient will maintain skin integrity
- The patient will demonstrate proper transfer techniques
- The patient will maintain adequate nutrition
Nursing Care Plan 4: Anxiety
Nursing Diagnosis Statement:
Anxiety related to fear of falling during transfers as evidenced by expressed concerns and hesitation during movement.
Related Factors:
- Previous falls
- Decreased confidence
- Limited support system
- Environmental uncertainties
Nursing Interventions and Rationales:
- Provide emotional support
Rationale: Builds confidence and trust - Teach coping strategies
Rationale: Reduces anxiety during transfers - Demonstrate safe transfer techniques
Rationale: Increases confidence through knowledge
Desired Outcomes:
- The patient will express decreased anxiety
- The patient will demonstrate confidence during transfers
- The patient will use learned coping strategies
Nursing Care Plan 5: Self-Care Deficit
Nursing Diagnosis Statement:
Self-Care Deficit related to impaired transfer ability as evidenced by inability to independently perform activities of daily living.
Related Factors:
- Physical limitations
- Fatigue
- Pain
- Environmental barriers
Nursing Interventions and Rationales:
- Assist with daily activities
Rationale: Maintains dignity while supporting independence - Teach energy conservation
Rationale: Maximizes available strength - Provide assistive devices
Rationale: Supports self-care activities
Desired Outcomes:
- The patient will demonstrate increased independence
- The patient will utilize assistive devices effectively
- The patient will maintain optimal self-care ability
References
- Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.
- Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
- Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
- Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
- Koch, M. A. G. R., Arleth, T., Rosenkrantz, O., Rudolph, S. S., & Steinmetz, J. (2024). Interhospital transfers in elderly trauma patients. Injury, 111998. https://doi.org/10.1016/j.injury.2024.111998
- Menon A, Korner-Bitensky N, Kastner M, et al. Strategies for rehabilitation professionals to move evidence-based knowledge into practice: a systematic review. 2009. In: Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK78286/
- Silvestri, L. A. (2023). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.
- Southern AP, Lopez RA, Patel PJ, et al. Assessment and Management of Traumatic Injuries in Older Adults. [Updated 2024 Sep 2]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK442020/
