In almost every facility I have worked, including hospitals, I have noticed a shortage of wheelchairs. Not only that, but wheelchair leg rests. Where do all of these go? I worked in one facility where the aide would spend an hour or two every morning searching rooms for the hidden leg rests and cushions.
If we spend between a half hour to an hour to locate equipment for one patient so they can be aligned and positioned correctly imagine what that does to productivity when we see eight to 10 patients a day. So, who is supposed to be responsible for the wheelchairs where I work? Nursing and the maintenance department.
I go back and forth with this. On one hand, if the therapy department is not responsible for the wheelchairs, we leave it up to nursing and maintenance to find the equipment to properly align the patients in chairs and give up one more skilled assessment that we are trained in. On the other hand, if we spend an hour locating all the equipment for one patient then properly align and position them for comfort and safety, there is no guarantee the wheelchair will still be in the patient's room the next day.
A big problem is when all the wheelchairs are cleaned. They are taken from the rooms, lined up, sprayed and wiped down weekly. But no one writes room numbers on the chairs prior to doing this. So imagine the confusion when the chairs are returned to each station. One nurse I met at a facility had the maintenance department weld the footrests onto the wheelchairs. This solved the missing footrest dilemma but interfered with transfers because the chairs could not be properly positioned at bed side. A suggestion at one place was to use wire to attach the footrests to the chair itself. This worked until a patient received a skin tear from the wire.
My solution: Nursing should be responsible to find and locate the wheelchairs and footrest and maintain this for every patient in a facility. Since we are using the interdisciplinary approach and teamwork is the key, all patient care departments should take some form of responsibility for the patients. Then when the patient is evaluated or on the next treatment session a proper assessment of wheelchair seating and positioning can be made by us. We can then use a sticker from the patient chart and place it on the back of the wheelchair.
Another issue is the shortage of chairs. This is a facility and administrator decision but should be brought to their attention by both nursing and the therapy department. If a facility has a shortage of medicine for patients what do they do? Order more. Yet if there is a shortage in equipment that provides mobility and strengthening, the process to order more is much slower. I have yet to see a facility run out of needles for patients but theraband takes weeks to get. Anyone else have solutions or ideas about this?