MAO Manual

SKILL 2 – CLOSING AND OPENING THE WHEELCHAIR

Skills Sheet – Closing and Opening the Wheelchair

Step

Completes Successfully?

Yes

No

1. Positions him/herself at the side of chair 2. Lifts up on the seat of the chair to close the frame 3. Places hands on metal bars on each side of seat

4. Pushes down on each side evenly so as to open the frame of the chair 5. Continues until the crossbar is fully open and the chair is completely deployed Instructor Signature: _________________________________________ Date: _____________

SKILL 3 – DEMONSTRATING WHEELCHAIR PROFICIENCY

Skills Sheet – Securing the Wheelchair and Patient

Step

Completes Successfully?

Yes

No

1. Removes and replaces both arms rests 2. Removes and replaces both leg rests and extenders 3. Locks and unlocks both brakes 4. Verbalizes 2 other inspection items on the wheelchair Instructor Signature: _________________________________________ Date: _____________

SKILL 4 – PLACING A SEATBELT ON WHEELCHAIR

Skills Sheet – Securing the Wheelchair and Patient

Step

Completes Successfully?

Yes

No

1. Opens wheelchair fully, applies brakes 2. Wraps seatbelt around rear vertical posts of chair 3. Threads seatbelt through arms of wheelchair and buckles seatbelt snugly over pateint’s lap Instructor Signature: _________________________________________ Date: _____________

SKILL 5 – SECURING THE WHEELCHAIR AND PATIENT

Skills Sheet – Securing the Wheelchair and Patient

Step

Completes Successfully?

Yes

No

1. Informs the patient of the procedure 2. Positions the wheelchair for tie down 3. Secures two straps to the front frame of wheelchair at no more than 45 degree angles 4. Secures two straps to the rear frame of wheelchair at not more than 45 degree angles.

5. Secures patient to chair using ADA 3-point restraint or equivalent. 6. Alternates straps so that ratchet, pull-through, and folding tie downs are all utilized Instructor Signature: _________________________________________ Date: _____________