Patient Transfer

Every question here, with the answer

1. A patient is transferred from a community hospital to a larger acute care facility. On arrival, which assessments and documentation should the receiving nurse prioritize to reduce missed safety issues? Select all that apply.

   1. Assess and document any drains.
   2. Inspect the skin and bony prominences for bruises, cuts, scrapes, skin tears, or pressure ulcers.
   3. Wait to assess wounds until the transferring facility sends additional records.
   4. Document access lines such as IVs, gastric tubes, and urinary catheters.
   5. Focus the initial assessment only on insurance approvals and bed assignment.

   Answer: Assess and document any drains., Inspect the skin and bony prominences for bruises, cuts, scrapes, skin tears, or pressure ulcers., Document access lines such as IVs, gastric tubes, and urinary catheters.

   The receiving nurse should complete a thorough assessment and document skin findings, wounds, access lines, and drains because these are key points where important information can be missed during interfacility transfer. Delaying wound assessment or focusing only on administrative issues can allow unrecognized problems to become the responsibility of the receiving facility and negatively affect care.

2. A postoperative patient is being transferred from the OR to the ICU. Which information should the transferring nurse emphasize in the verbal report?

   1. The outpatient rehabilitation plan and possible insurance limitations.
   2. Current IV medications, recent labs and vital signs, skin condition, wounds, surgical lines, and drains.
   3. The patient’s continence before surgery and long-term mobility goals.
   4. The patient’s personal mementos and preferred family visiting times.

   Answer: Current IV medications, recent labs and vital signs, skin condition, wounds, surgical lines, and drains.

   For an OR-to-ICU transfer, the receiving nurse needs high-acuity information that affects immediate monitoring and care, including IV medications, labs, vital signs, skin, wounds, lines, and drains. Continence, mobility, belongings, and longer-term plans may matter later but are not the priority focus for this transfer report.

3. A patient no longer needs acute inpatient care but is being transferred to an extended care facility because significant medical needs remain. Besides vital signs, which information should the nurse make sure is included in report? Select all that apply.

   1. Mobility status.
   2. Whether the sending unit has visitation limitations.
   3. Medications.
   4. Orientation status.
   5. Wounds.

   Answer: Mobility status., Medications., Orientation status., Wounds.

   For transfer to an extended care facility, the report should be complete but focused on what that facility needs to safely continue care. Orientation, mobility, medications, and wounds are identified as the most important facts besides vital signs; visitation limits from the sending unit are not listed as a key report priority.

4. A patient is scheduled to leave the unit by ambulance for transfer to another facility. Before departure, which actions should the nurse coordinate or complete? Select all that apply.

   1. Confirm that the doctors are aware and that the charge nurse and unit clerk have been notified.
   2. Prepare the patient by addressing needs such as dressing, cleaning, ambulating, or toileting.
   3. Skip report if transport has already arrived and send the patient immediately.
   4. Pack the patient’s belongings.
   5. Give report to the receiving facility.

   Answer: Confirm that the doctors are aware and that the charge nurse and unit clerk have been notified., Prepare the patient by addressing needs such as dressing, cleaning, ambulating, or toileting., Pack the patient’s belongings., Give report to the receiving facility.

   Regardless of the transport method, the nurse is responsible for coordinating departure with the team, giving report, packing belongings, and preparing the patient. Sending the patient without report creates risk because the receiving facility may not have the information needed for safe care.

5. A nonemergent transfer is planned for this afternoon. The patient’s family will not be able to visit until this evening, after the transfer has taken place. What is the best nursing action?

   1. Notify the family only if the transfer becomes emergent.
   2. Document the transfer in the chart and notify only the receiving nurse.
   3. Call the family with a simple update about the transfer.
   4. Wait for the family to call the unit so they do not become worried.

   Answer: Call the family with a simple update about the transfer.

   When the family cannot be present closer to the transfer time or afterward, a simple phone call update supports clear communication and comfort. Waiting for them to discover the transfer or relying only on chart documentation does not meet the communication need described in the section.

6. A patient who does not want chest compressions if their heart stops is being transferred to an outside facility. What is the nurse’s priority related to the transfer report?

   1. Clearly communicate the patient’s code status and advance directives as part of the report.
   2. Send the advance directives only with the patient’s belongings.
   3. Focus on mobility and wounds first because advance directives are handled after arrival.
   4. Mention the advance directives only if the receiving nurse asks.

   Answer: Clearly communicate the patient’s code status and advance directives as part of the report.

   Code status and advance directives must be clearly conveyed during transfer, especially to an outside facility, because unclear communication can cause distress and legal problems. Sending the information only with belongings or waiting to be asked leaves room for error.