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Mobility disabilities: A technical assistance manual for health care providers ...continued from page 5 down. Similarly, if an examination calls for a specialized position, such as a gynecological examination, then a person with a disability must be able to access the equipment used for that examination. attached to the ceiling and run along one or more tracks. Free-standing overhead lifts are supported by a frame that rests on the floor. They work well when the provider does not want the lift to be permanently installed or where the existing ceiling structure cannot mammography machine will need to adjust to the individual’s height in the wheelchair or other chair. For weight scales, the technical assistance manual recognizes the importance of a patient’s weight for diagnostics and treatment, but acknowledges that individuals Traditional fixed-height tables and chairs are too high for many persons with mobility disabilities. Adjustable-height tables are better suited for them. At a minimum, an accessible exam table or chair should have (1) the ability to lower to the height of a wheelchair seat, 17-19 inches (possibly lower) from the floor, and (2) features, such as rails, straps, stabilization cushions, wedges, or rolled up towels, which stabilize and support a patient during the transfer and while on the table. The ability to get on to an exam table is a function of the patient’s capabilities and disability, as some persons may be able to affect the transfer without any assistance, but others may require help from a staff member or some other device, such as a transfer board or patient lift. support a ceiling-mounted lift. In some instances, neither a portable lift nor ceiling-mounted lift is feasible or possible. Such is the case where, for example, the medical equipment to be used lacks space to accommodate a lift or the metal components of a lift may not be compatible with some radiologic technologies. In these circumstances, an adjustable-height stretcher or gurney may be used. This typically entails a two-step process in which the patient first transfers from the wheelchair to the stretcher, and then from the stretcher to the table. Radiologic technologies and equipment, such as MRI, x-ray, CT scan, bone densitometry, and ultrasound machines present additional challenges. Because many of the technologies who use wheelchairs often are not weighed at the doctor’s office or hospital, because the provider does not have a scale that can accommodate a wheelchair. For this reason, the manual recommends that medical providers have either a scale with a platform large enough to accommodate a wheelchair, or a scale that is already integrated into a patient lift, hospital bed, or exam table. Properly trained staff Although the technical assistance manual focuses, in large part, on accessible equipment for people with mobility disabilities, it also emphasizes the importance of staff training in helping to ensure that such patients have an equal opportunity to receive accessible health care services. Accessible medical equipment can only do so much, unless staff knows A transfer board is made of a smooth rigid material which acts as a bridge between a wheelchair and another surface, along which the individual slides. A patient lift is a more elaborate device, and generally involves a sling, which is attached to a lift, and positioned under the patient who is sitting in a wheelchair. Once the person is moved to the table, he or she is then lowered onto the table, stabilized, and the sling is detached from the lift. are integrated into the table, the table may not be capable of being lowered sufficiently. Consequently, a patient lift or other transferand-position technique is especially important for access to this equipment. In addition, many of these technologies require the patient to keep still, which may be particularly difficult for some persons with mobility disabilities. In such circumstances, a staff person may need to hold on to the patient or support them with pillows, rolled-up towels, where it is stored and how to operate it. The guidance suggests that when new equipment is acquired, staff should be immediately trained on its use and maintenance. Similarly, new staff should be trained as soon as they are hired, and all staff should receive annual refresher training regarding the accessible medical equipment. Finally, the technical assistance manual stresses the importance of instructing and The most common types of lifts in medical settings are portable lifts. These typically have a U-shaped base that moves along the floor on wheels. The base goes under or fits around the exam table. Although these lifts can be moved from room to room, they require more maneuvering and storage space than overhead lifts, of which there are two general or wedges. The technical assistance manual also provides guidance on two others types of equipment: mammography equipment and scales. For mammography, wheelchair-bound patients and individuals who cannot stand for prolonged periods of time will have to be encouraging staff to ask questions of the patient, such as whether they need help and if so, how best they can help the individual. Because people with mobility disabilities use devices of different types, sizes, and weights, transfer in different ways, and have differing levels of physical abilities, understanding what assistance, if any, is needed and how to types. Ceiling-mounted lifts are permanently examined while the person is seated, so the Continued on page 8 <strong>Health</strong> <strong>Care</strong> <strong>Compliance</strong> <strong>Association</strong> • 888-580-8373 • www.hcca-info.org 7 December 2010
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