How do slide sheets and lateral transfers work safely?
Slide sheets work by replacing the friction between a patient and the bed with two layers of low-friction fabric sliding over each other, so that staff move the patient with a controlled weight transfer rather than a lift. Used properly, with the bed at working height, brakes on, two staff for a bed move and three or four for a lateral transfer, an agreed command and one person responsible for the lines, they take most of the force out of the two commonest patient handling tasks in a hospital. Used badly, or skipped because they are down the corridor, those same tasks are the ones that injure nurses.
Last reviewed September 2026 · Applies to the Manual Handling Training for Nurses and Healthcare Workers course.
Setting up: bed height, brakes and staff
Almost every slide sheet injury starts before the sheet is touched. The bed is left low, so both staff work bent forward; the brakes are off, so the bed drifts; the bed head is up, so the patient is being pushed uphill; or one nurse decides to do a two-person task alone because the ward is busy. Set the bed at the working height of the shorter person, roughly hip height, put the brakes on, flatten the bed unless the patient cannot tolerate it, and get the second person into the room before you start.
Two staff is the minimum for moving a dependent patient up or across a bed with slide sheets, and your procedure will say so. The two of you stand one each side, feet apart and facing the direction of travel, and move the patient with your body weight shifting from the back foot to the front foot. Nobody lifts, and nobody pulls with their arms alone.
Communication is a control, not a courtesy. Agree who is leading, agree the command, usually ready, steady, slide, and agree what the patient is being asked to do, whether that is tucking their chin, holding their arms across their chest or pushing with their heels. Tell the patient what is about to happen and gain their agreement before you move them.
- Bed at working height, brakes on, bed flat, rails down on the working side
- Two slide sheets or a folded tube sheet from shoulders to below the hips, inserted by rolling
- Two staff, one each side, weight transfer rather than arm pull
- One leader, one command, the patient told and prepared
- Sheets removed afterwards unless designed to stay in place, then the bed lowered again
Slide sheets, pat slides and air-assisted devices
A slide sheet, whether a flat pair or a tube, is for moving a patient over a surface they are already on: up the bed, across the bed, or rolling. It does not bridge a gap. A pat slide, also called a transfer board, is a rigid board that bridges the gap between two surfaces such as a bed and a trolley, and it is used together with slide sheets so the patient slides across the board rather than being lifted over it. Using a board without sheets on top drags the patient across a hard surface and needs far more force.
An air-assisted lateral transfer device is an inflatable mattress that stays under the patient and floats them across on a cushion of air from perforations underneath. It cuts the force of a lateral transfer dramatically and is the standard where available for bariatric patients, intensive care patients on ventilators and multiple lines, and theatre patients. It needs its own set-up, including a power supply and a check that the mattress is rated for the patient, so it is planned rather than grabbed at the last moment.
Whichever device you use, check it before it goes under a patient: no tears in the fabric, no cracks in the board, the tube sheet the right way round, and the item clean or single-patient-use as your infection control policy requires. Slide sheets left under a patient who is not on a sheet designed for that purpose become a friction and moisture hazard for their skin.
The lateral transfer step by step
Bring the two surfaces together and apply the brakes on both. Close any gap and set the receiving surface slightly lower than the one the patient is on, so gravity helps. Roll the patient towards the staff on the far side, place the pat slide and the slide sheets under them so that the board bridges the gap, and roll them back onto the sheets. Check that the patient is centred and their arms are across their chest.
Lines, drains and attachments are dealt with before the move, not during it. Reposition the IV pole to the receiving side, give the catheter bag and any drains enough slack and clip them where they will not be crushed, move the oxygen tubing or cylinder, and make one person responsible for the head, the airway and the lines and nothing else. That person gives the command.
Staff on the receiving side take hold of the slide sheet and pull it towards themselves with a weight transfer; staff on the far side guide the patient and prevent them rolling off the board. Move in two or three short controlled slides rather than one heave. Your procedure will specify the number of staff, commonly three or four and more for a heavy or ventilated patient, and that number is not negotiable because the ward is short. Afterwards, remove the board and sheets, check the patient's skin and every attachment, and settle them before you leave.
Module 6 (Patient Handling in Clinical Settings) covers bed mobility and lateral transfers in this detail, including moving patients with lines and drains, and Module 7 (Clinical Equipment and Handling Aids) covers slide sheets, transfer boards and air-assisted devices with pre-use checks and infection control. Reading it will not make you competent to use any of them; your health service must show you its own devices and assess you on them, and that is where its duty starts and ours stops.
Common questions
Sources
- Safe Work Australia — Model Code of Practice: Hazardous manual tasks — The national code the state and territory regulators adopt or mirror.
- Safe Work Australia — Lifting, pushing and pulling (manual tasks)
- Safe Work Australia — Health care and social assistance industry
General information about Australian work health and safety duties, not legal advice. Your employer’s procedures and the regulator in your state take precedence.
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