sampleWheelchair Safety Awareness

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Wheelchair Safety Awareness

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N.B: We are aware that official practice is to use the terms “service users” or “people using this service” to describe those receiving care. We prefer the term “client” and use it throughout our training package.

Key:

worksheet important

Contents

Index. Page 2 Learning outcomes. Page 3Fundamental standards. Pages 3 - 4Introduction. Page 5

Unit One. Pages 6 - 10Why wheelchair safety is important.Unit One Questions. Page 11

Unit Two. Pages 12 - 16Wheelchair checks.Unit Two Questions. Page 17

Unit Three. Pages 18 - 22Principles of movement / Risk Assessment.Unit Three Questions. Page 23

Unit Four. Pages 24 - 28Wheelchair safety in use.Unit Four Questions. Page 29

Unit Five. Pages 30 - 33Safety when transporting wheelchairs.Unit Five Questions. Page 34

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Unit Three

Principles of movement / Risk Assessment.

As with all equipment that requires the use of moving and handling it is important that you use the principles of efficient movement when doing manoeuvres or transfers with wheelchairs. This will help to ensure the safety of yourself and those you are supporting.

The principles of efficient movement.

A dynamic, stable base.

By understanding how your body works you can learn to carry out handling tasks in a way that is safer for yourself and your colleagues and clients. The traditional approach to manual handling has been to teach set techniques; a better way to encourage you to work safely is to teach you how to use your body properly and how to assess risk.

To allow your muscles to work properly you must first have a dynamic, stable base to build on. Stable so that you’re balanced and unlikely to fall over and dynamic to allow for movement. Your feet should be placed about hip distance apart with one slightly in front of the other and pointing in the direction of intended movement.

Pointing your foot in the direction you will move enables the tendon at the back of the ankle to help power the move forward. As you move you transfer your weight from one leg to the other, a dynamic stable base allows you to use your bodyweight to aid movement (for example when pushing a wheelchair), rather than relying on muscular strength.

Knees and hips.

Previously you may have been taught to ‘bend’ your knees when lifting to encourage use of the large muscles in the thighs and to protect your back. The term ‘bend’ has fallen out of favour as you can hurt yourself if you bend your legs at too great an angle. Try squatting as low as you can and consider how unstable you become, how uncomfortable the position is and how difficult it can be to straighten up.

By flexing or ‘softening’ your knees you reduce tension in your body and encourage natural movement. If you need to get to a lower position flex your hips as well.

Any tension in your body will contribute to your risk of getting injured; concentrate on keeping your joints as relaxed as possible throughout manoeuvres. You should also be aware that tension can be caused by stress and illness, so you are more likely to be hurt if you are not psychologically and physically fit.

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Your spine.

It’s likely that throughout your life people have been telling you to keep your back straight. Would it be nice to tell them they are wrong? Spines are not straight, they have natural curves and are often described as being a kind of lazy ‘s’ shape. Your spine should be kept in the position that is natural and comfortable for it. If a tilt forward is needed this should be achieved by softening of the hips and knees rather than top heavy bending of the spine.

There are many activities that you may do each day that encourage you to adopt a position where you bend forwards from your shoulders. If you are ironing, washing up, bed making or preparing vegetables the likelihood is that your posture will be putting you at risk. After 5 minutes in this position your chance of injury is increased by 40%.

Head and chin.

Keep your head up and your chin tucked in to maintain the natural curves of your spine.

Arms.

The closer to your body you keep the load the safer the manoeuvre will be. Your elbows should be tucked in at your sides when lifting and carrying to allow them to work most efficiently as levers. There will be times when you have no choice but to stretch your arms out while carrying out a task, but take this into consideration when planning beforehand so you can reduce the amount of time you spend in this position.

Hands.

If you grip things with your fingertips you will create tension in your hands and up your arms. If you handle a client this way you may cause damage to their skin or bruising. Aim to handle things using the palm of your hand in as much contact with the object as possible. When assisting clients provide support for their limbs from below rather than lifting them from above. Equipment like hoists and wheelchairs don’t need to be gripped to be controlled; you can move it more safely with open, relaxed hands.

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Breathing.

If your abdominal muscles are in good shape you can help to protect your spine by taking a deep breath in before the most strenuous part of an activity. This pushes the diaphragm down and causes the abdominal muscles to contract and support for the front of the spine increases. This can significantly reduce the stress on your discs.

Risk Assessment.

All work tasks require risk assessments to be carried out, to help you to address any safety issues and put measures in place to control them. When carrying out a risk assessment for using a wheelchair the following points should be looked at.

The task, the person who is either doing the task or supporting the person using the wheelchair, the person actually using the wheelchair, the environment it is being used in and the equipment required.

The following mnemonic can help you to remember it

T TaskI IndividualL LoadE EnvironmentE Equipment

Task:

Identify what the task is. Some examples could be moving someone from a chair or bed to a wheelchair, transporting someone from one room to another by means of a wheelchair, supporting someone in the use of a wheelchair.

Individual:

This will usually be the person carrying out the task. We need to look at whether they have been trained in the requirements of the task. It is also important to look at their physical limitations in relation to the task and whether they have any pre existing injuries. Clothing and footwear suitable to the task should also be considered.

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Load.

The load in this case will be the person using the wheelchair. We need to consider the person’s body proportions, their upper torso height and mass, whether they are obese, whether there is any lower limb wasting or amputation and their mobility. Then we need to check the following:

• Is their weight within safe working limits for the wheelchair being used.

• Can they be correctly positioned when in the wheelchair.• Are they likely to shift or tip when in the wheelchair.

Environment:

We need to think about whether the environment is safe and clear of hazards. Avoid using kerbs unless they are dropped kerbs. Wheelchairs are designed to be moved forward and should not be dragged backwards except under exceptional circumstances. The environment can be internal or external. It may be necessary to walk the route to identify the hazards. The following areas should be considered.

Internal.

• Floor surfaces should be clear.• Space to manoeuvre the wheelchair.• Door frames that are wide enough / suitable thresholds.• Changes in floor height.• Ensure lighting is good.• Space to park the wheelchair.

External.

• Hills and slopes should be checked for suitability.• Check there are ramps to enter buildings etc.• Check where there are sloping pavements or dropped kerbs.• Always consider the weather as this will have a bearing on the operation of the wheelchair.

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Think about a route you walk regularly, maybe from your house or workplace. Imagine using this route in a wheelchair and write down all of the hazards that you might encounter.

Equipment:

• Is wheelchair operating within its safe working load limit?• Consider the effects of the addition of accessories or other equipment.• Ensure there are no inappropriate adjustments or modifications to the wheelchair.• Has the equipment been properly maintained and regular checks been carried out.

Using the information collected from the previous exercise identify what measures you should put in place to make the route safe.

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Why is it important to use the principles of movement when doing manoeuvres or transfers using a wheelchair?

1.

Unit Three Questions

What does TILEE stand for?2.

Why do we need to do a risk assessment before using a wheelchair?3.

When looking at the environment we will use the wheelchair in, give two examples of factors we should consider for each of the following.

5.

2.

1.

Why is it important to check the load weight of the wheelchair?4.

a. Internal

b. External