Clinician training · Acute care & ICU

Line Management During Transfers & ADLs

A training guide for moving patients safely when they're connected to lines, drains and tubes. Scan, count, trace, secure before every transfer and ADL.

Audience: Therapists, nurses, aides, students
Setting: Acute care & ICU
Format: Training guide + line cards
Pairs with: Clinical Reasoning Sheet, Bed QR Codes

The project

Problem

A pulled IV, chest tube or feeding tube during mobility is a real safety event. Therapists new to acute care, ICU or trauma often aren't sure what they can move, what to protect, and when to stop and call the nurse.

Solution

One routine for every session, a card for each line type in the same layout, and clear steps for what to do if something comes out. New staff learn it with a return demonstration before working alone.

Who uses it

Therapists starting in acute care or ICU, float and travel staff, nurses and aides who mobilize patients, and students. It builds on my acute care safety checklist.

The project · Line management guide

Every session

Scan for lines

The same eight steps before and after every transfer, bed mobility or ADL session. Try it: check off each step.

Line scan0 of 8 done

Before you move

Check with the nurseNew lines, activity orders, and anything that needs nursing first, like a drain to clamp or a feed to pause.
Scan and countLook head to toe and count every line, drain and tube. Write the number down.
Trace each oneFollow it from the patient to its pump, bag, monitor or wall. Look for snags on rails, the bed frame or the gown.
Plan your directionTransfer toward the side the lines are on, so they come with the patient instead of being pulled across.
Give slack and secureMove poles and bags first. Clip drains to the gown. Hang bags on the bed frame or chair, never on a moving rail.

During

Watch the lines as you moveOne person watches lines on complex patients. Stop if anything pulls tight.

After

Re-countSame number as before? Check each site and connection.
Reset and hand offBags below the right level, pumps running, monitor reading. Tell the nurse anything that changed.

Count your lines before you start.

Count before, count after

The simplest safety check: the number of lines at the start should match the end. A missing one means stop and look.

2IV / PICC

1Monitor

1Oxygen

2Drains

Example: 6 lines, post-op patient

Printed as a pocket card

The same eight steps fit on a badge-sized card and a poster for the rehab gym and unit workrooms.

One per line type

Line cards

Every card uses the same four parts, so staff know where to look. Red cards mean the nurse must be involved before any position change.

If something comes out

Stop. Stay with the patient.

1Stop
Stop the activity. Don't try to put anything back in.
2Keep them safe
Get the patient to a safe, supported position: bed, chair or seated.
3Protect the site
With gloves, cover the site and hold pressure if it's bleeding.
4Call the nurse
Use the call light or call out. Don't leave the patient alone.
5Document
What came out, when, and what you did, per hospital policy.

Return demonstration

Competency checklist

ObserveCo-treatTreat with backupIndependent

Skill	Shown by mentor	Return demo	Signed off
Completes the line scan and count before and after a session
Transfers bed to chair with IV, oxygen and monitor leads
Bed mobility with a chest tube, keeping the drainage below the chest
Dressing with an IV or PICC: threads the bag and line through the sleeve first
Walks with a Foley and surgical drains secured
Coordinates with the nurse for a feeding tube or nurse-first line
States the "if something comes out" steps

The full kit

Line scan card

An illustrated, one-page checklist and a badge-sized version.

Line cards

One printable card per line type, all in the same layout.

Unit poster

The pre-mobility routine for the rehab gym and unit workrooms.

Competency sheet

Return demonstration sign-off for new therapists and floats.

Specific handling rules, such as clamping, pausing tube feeds, head-of-bed angles and oxygen changes, follow hospital policy and nursing guidance.