A protocol for assessment of risk in wheelchair driving within a healthcare facility.
OBJECTIVE
The purpose of this article is to describe how a skilled nursing facility with significant wheelchair traffic developed a protocol for the multidisciplinary assessment and intervention management of patients whose wheelchair use represents a risk to self and others. This article describes the procedure and two case studies illustrating the utility of the protocol.


METHODS
Staff of the facility developed a protocol for responding to sentinel events related to patients hurting themselves and others while using a wheelchair or observed using the wheelchair in an unsafe manner. The goal of the protocol is to determine the cause of the event, identify the necessary multidisciplinary interventions, and the evaluation of the effectiveness of the interventions.


RESULTS
Case study analysis of the interventions indicated that a multidisciplinary evaluation and treatment plan leads to treatment interventions that suit the patient's medical condition while affording the patient the greatest amount of independence.


CONCLUSIONS
Many patients who live in a long-term skilled nursing facility must use either a manual or a power wheelchair for mobility. For these patients, the wheelchair may represent one of the last forms of independence they enjoy. The implementation of the protocol helped staff respond to important changes to the patient's condition and prepare a coordinated intervention. The patients found the protocol to be a helpful component of their treatment.
Mendoza
Robert J
RJ
The Boston Home, 2049 Dorchester Avenue, Dorchester, MA 02124-4799, USA. Rjmdc2001@aol.com
Pittenger
David J
DJ
Saftler Savage
Faith
F
Weinstein
Cheryl S
CS
D000059:Accidents; D000368:Aged; D001900:Boston; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment / Q000592:standards*; D012449:Safety; D012866:Skilled Nursing Facilities / Q000592:standards*; D014910:Wheelchairs / Q000592:standards*