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Are You Using Best Practices to Answer OASIS M1850 - "Transferring"?

Posted by Melissa Cott on Nov 14, 2017

Include the following evidence-based OASIS C1 best clinical practices for M1850 Transferring:

(M1850) Transferring: Current ability to move safely from bed to chair, or ability to turn and
position self in bed if patient is
bedfast.

Identifies current ability to move safely from bed to chair, or ability to turn and position self in bed if patient is bedfast.

  • 0 - Able to independently transfer.
  • 1 - Able to transfer with minimal human assistance or with use of an assistive device.OASIS Home health Process Measures
  • 2 - Able to bear weight and pivot during the transfer process but unable to transfer self.
  • 3 - Unable to transfer self and is unable to bear weight or pivot when transferred by another person.
  • 4 - Bedfast, unable to transfer but is able to turn and position self in bed.
  • 5 - Bedfast, unable to transfer and is unable to turn and position self.

This OASIS item identifies the patient’s ability to safely transfer from bed to chair (and chair to bed), or position self in bed if bedfast. The intent of the item is to identify the patient’s ABILITY, not necessarily actual performance. "Willingness" and "adherence" are not the focus of these items. These items address the patient's ability to safely transfer, given the current physical and mental/emotional/cognitive status, activities permitted, and environment. The patient must be viewed from a holistic persp

Best Practice Assessment Strategies for M1850

  • For most patients, the transfer between bed and chair will include transferring from a supine position in bed to a sitting position at the bedside, then some type of standing, stand-pivot, or sliding board transfer to a chair, and back into bed from the chair or sitting surface. - If there is no chair in the patient’s bedroom or the patient does not routinely transfer from the bed dirambulation_3.jpgectly into a chair in the bedroom, report the patient’s ability to move from a supine position in bed to a sitting position at the side of the bed, and then the ability to stand and then sit on whatever surface is applicable to the patient’s environment and need, (for example, a chair in another room, a bedside commode, the toilet, a bench, etc.). Include the ability to return back into bed from the sitting surface.
  • The patient’s ability may change as the patient’s condition improves or declines, as medical restrictions are imposed or lifted, or as the environment is modified. The clinician must consider what the patient is able to do on the day of the assessment. If ability varies over time, choose the response describing the patient’s ability more than 50% of the time period under consideration.
  • The transferring scale presents the most optimal level first, then proceeds to less optimal levels of transferring. Read each response carefully to determine which one best describes what the patient is able to do.
  • Able to bear weight refers to the patient's ability to support the majority of his/her body weight through any combination of weight-bearing extremities (for example, a patient with a weight-bearing restriction of one lower extremity may be able to support his/her entire weight through the other lower extremity and upper extremities). If the patient is able to transfer self from bed to chair, but requires standby assistance to transfer safely, or requires verbal cueing/reminders, select Response 1.
  • A combined observation/interview approach with the patient or caregiver is helpful in determining the most accurate response for this item. Ask the patient about transferring ability. Observe the patient during transfers and determine the amount of assistance required for safe transfer from bed to chair.

 

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