Wheelchair to Dental Chair: Safe and smooth patient transfers

Dental practices welcome patients of all ages and abilities. While most patients come and go without incident, those with limited mobility may need help transferring to and from the dental chair. In an ideal scenario, these patients will bring along a caregiver or family member to help with transfers. In other cases, it is up to the dental practice to provide solutions.

Not only are practice owners required to make their office spaces wheelchair accessible, they are also obligated to ensure all patients have equal access to dental care. For those patients who have a long-term disability as defined by the Americans with Disabilities Act, they must make a reasonable effort to move the patient. However, this type of physical assistance is not without risk. If moving a patient causes physical injury to the patient or the staff member, it can put the practice at risk for a liability claim. If practice owners refuse to move a patient for fear of injury, it can lead to unhappy patients.

In one case, a dentist contacted The Dentists Insurance Company’s Risk Management Advice Line to ask if he was responsible for moving a patient from his wheelchair to the operatory chair. The patient in question was a long-term patient who usually came to his appointments with his son or a caregiver. In this instance, the caregiver had left the office to run an errand, so the patient asked the dental assistant if the office staff could help him transition to the dental chair. The dentist felt that his team could not safely move the patient. He explained to the patient that he had a bad back and did not want to risk further injuring himself. Staff waited for the caregiver to return, but the patient became upset and believed the office should provide this kind of assistance.

TDIC’s Risk Management analyst advised the dentist that waiting for the caregiver to return was the best decision in this case. Safety is of the utmost importance in the dental office. It is not worth risking an injury, either to the patient or staff members.

In another case reported to the Advice Line, a male staff member had assisted a patient in a wheelchair. In doing so, the employee sustained a shoulder injury that required surgery. The incident resulted in a Workers’ Compensation claim. In a Risk Management analyst’s discussion with the dentist, it was determined that the employee had no training in providing this type of assistance to patients. The office relied on the employee because he was the only male in the office and the dentist perceived him to be the strongest.

The analyst advised the caller that depending on staff for patient transfers should only be considered as a last resort. If a patient with limited mobility presents without a caregiver or family member to assist, the first step is to ask whether the patient has the upper body strength to transition themselves to the chair. If not, practices should ensure employees tasked with this responsibility are willing and able to do so, are not at risk for exacerbating a previous injury, and are trained on the proper method on transferring patients.

The National Institute of Dental and Craniofacial Research has developed a downloadable guide on safe patient transfers using the two-person method. In this method, one clinician stands behind the patient while another initiates the lift from the patient’s legs. The method consists of six steps:

1. Determine the patient’s needs.
2. Prepare the dental operatory.
3. Prepare the patient’s wheelchair.
4. Perform the two-person transfer.
5. Position the patient after the transfer.
6. Transfer the patient from the dental chair to the wheelchair.

Practice owners are encouraged to provide training to staff members on these methods. The training should include a “practice run” or role-playing exercise where employees are able to become comfortable with the method prior to using it on patients.

There may be patients who are too heavy or too fragile to lift using this two-person method. In these cases, the practice can also rent a hydraulic or manual patient lift. These lifts ease patient transfers through the use of a sling. Offices with a high number of patients with limited mobility may consider purchasing a lift.

While practice owners should be proactive in meeting the needs of all of their patients, those with limited mobility often require additional assistance. Developing strategies for transferring these patients to and from the dental chair ahead of time can avoid uncomfortable or risky situations. No matter the method or mode a practice decides to implement, patients and staff will appreciate that you have formulated a plan with their comfort and safety in mind.