Can a patient receive a power wheelchair during hospital admission?

Power Wheelchair Provision During Hospital Admission

Yes, patients can receive a power wheelchair while admitted to a hospital, particularly when the wheelchair is needed to support mobility, prevent complications, and improve quality of life during the hospitalization.

Assessment for Power Wheelchair Need During Hospitalization

When considering power wheelchair provision during hospitalization, healthcare providers should evaluate:

• Patient's mobility status and functional limitations
• Expected duration of hospitalization
• Potential for rehabilitation and recovery
• Safety considerations within the hospital environment
• Patient's cognitive and physical ability to operate the device

Guidelines Supporting Wheelchair Provision

Current clinical practice guidelines support the use of wheelchairs for hospitalized patients with mobility limitations:

• The American Heart Association/American Stroke Association guidelines explicitly state: "Wheelchairs should be used for nonambulatory individuals or those with limited walking ability" 1
• The Management of Adult Stroke Rehabilitation Care guideline recommends: "Wheelchair prescriptions be based on careful assessment of the patient and the environment in which the wheelchair will be used" 1

Implementation Process

1. Initial Assessment:

   • Rehabilitation professionals should assess the patient within 48 hours of admission 1
   • Evaluate mobility needs, safety concerns, and potential benefits of power wheelchair use

2. Wheelchair Selection:

   • Power wheelchairs are particularly beneficial for patients who lack sufficient upper body strength to operate manual wheelchairs 2
   • The wheelchair should be specifically matched to the patient's physical limitations and the hospital environment

3. Safety Considerations:

   • Develop a protocol for assessment of wheelchair driving safety within the healthcare facility 3
   • Monitor for potential risks to the patient and others in the hospital environment
   • Consider implementing a multidisciplinary evaluation process for patients using power wheelchairs 3

4. Training and Support:

   • Provide adequate training on wheelchair operation
   • Ensure staff are trained to assist with wheelchair use and transfers
   • Regular monitoring of skin integrity for patients using wheelchairs 1

Special Considerations

• Skin Care: Daily skin assessments are essential for patients using wheelchairs to prevent pressure injuries 1
• Transportation: When moving patients between departments, ensure appropriate support for safe wheelchair use 1
• Mobilization Goals: Balance the use of wheelchairs with appropriate early mobilization goals (between 24-48 hours post-admission) 1

Common Pitfalls to Avoid

1. Inappropriate Selection: Not all patients will benefit from power wheelchairs; some may require manual wheelchairs or other mobility aids based on their specific needs and abilities

2. Inadequate Training: Failure to properly train patients on wheelchair operation can lead to accidents and injuries

3. Neglecting Skin Care: Without proper cushioning and regular position changes, wheelchair use can lead to pressure injuries

4. Environmental Barriers: Hospital rooms and hallways must accommodate wheelchair use; assess for potential barriers

Conclusion

Power wheelchairs can be provided during hospitalization when appropriate for the patient's mobility needs. The decision should be based on a thorough assessment of the patient's condition, the hospital environment, and safety considerations. Early involvement of rehabilitation professionals is essential to determine the most appropriate mobility solution for each patient.