Sit-to-Stand Observation

• Name of Employee

• Location
  Address

• Conducted on

  Date

• Prepared by: K. Thomas

• Sling and lift inspected prior to use.

  Yes

  No

  N/A

• Informs the person served who they are and what they are going to do, and communicates the lift procedure to the person served

  Yes

  No

  N/A

• Raises the height of the bed to an appropriate level, if transferring from bed

  Yes

  No

  N/A

• Places the lift in front of the person served and, if able, asks the person to place feet on the footplate, if applicable, or assists them as necessary.

  Yes

  No

  N/A

• Places a strap around lower legs, if applicable, or under thighs, if applicable.

  Yes

  No

  N/A

• Places a sling around the person with arms outside of the sling, if applicable.

  Yes

  No

  N/A

• Secures the belt around the person's waist.

  Yes

  No

  N/A

• Ensures the person grasps handles

  Yes

  No

  N/A

• Demonstrates proper techniques for maneuvering the lift.

  Yes

  No

  N/A

• Demonstrates proper techniques for lowering to chair/bed.

  Yes

  No

  N/A

• Demonstrates proper techniques for removing sling/straps.

  Yes

  No

  N/A

• If answered No to any of the above questions, provide details

PASS/FAIL

• Can the employee safely transfer persons served using the sit-to-stand?

  Pass

  Fail

  N/A

• If "Fail", please provide recommendations.