A finger amputation while opening a wheelchair prompted the Patient Safety Authority (PSA) to issue a Safety Alert about wheelchair-related finger injuries. The alert warns the public and healthcare facilities to be vigilant when unfolding or sitting in the device.
Hundreds of wheelchair-related injuries have been reported nationwide into the Food and Drug Administration’s Manufacturer and User Facility Device Experience (MAUDE) reporting system.
Improperly opening a folded wheelchair can cause finger injuries, including amputation, bone fractures, nail loss, cuts, crushing, and pinching. Some reported injuries occurred when users placed their hand on the seat to open the chair. Others happened when the user tried to sit in the chair to unfold it.
Wheelchairs are one of the most common assistive devices used in healthcare facilities, as well as malls, airports, arenas, courthouses, houses of worship, and other public buildings. They are often opened by volunteers, untrained staff, the users themselves, or their family members. Anyone who operates a wheelchair should read and understand the manufacturer's instructions before use.
Wheelchairs are deceptively simple
“The big challenge is that wheelchairs seem so simple to use. Yet, there are so many different types of chairs that there isn’t a one-size-fits-all way to open them properly,” notes PSA Patient Safely Liaison Molly Quesenberry, whose research led to the Safety Alert. "You really need the manufacturer’s instructions.”
“Despite being an RN, I was never personally trained on how to unfold a wheelchair properly. I never realized the danger of losing a finger by improperly unfolding a wheelchair.”
She recommends that facilities consider replacing folding wheelchairs with rigid frame ones or using an anti-fold device to keep them open, if available.
PSA has also created a warning tag to urge the public to ask for assistance with a folded wheelchair and disseminated it to all Pennsylvania healthcare facilities. https://patientsafetyj.com/index.php/patientsaf/article/view/wheelchair-risks/wheelchair-tags
Four additional wheelchair safety tips
- Check that the brakes are locked before sitting down in a wheelchair
- Use proper hand hygiene before and after use to decrease your risk of infection and illness
- Use extreme caution when considering buying used equipment
- Ensure seats are fully engaged before allowing someone to sit in the wheelchair
“Wheelchairs are readily available from second-party vendors, such as Facebook Marketplace and EBay, but the safest choice is to purchase from a medical equipment company,” advises Quesenberry. “Get proof that it has been inspected and maintained and that the original manufacturer instructions are included.”
Pennsylvania is the only state that requires healthcare facilities to report harmful events, as well as those that do not result in patient harm (i.e., near misses) but may be a harbinger of a potentially serious problem. The reports are collected in the Pennsylvania Patient Safety Reporting System (PA-PSRS), the largest repository of its kind in the United States.
The PSA analyzes those events, facilitates widescale performance improvement projects, and shares the information globally.
The PSA is an independent state agency that collects and analyzes patient safety data to improve safety outcomes and help prevent patient harm.
Established under the Medical Care Availability and Reduction of Error (MCARE) Act of 2002, the PSA, an independent state agency, collects and analyzes patient safety data to improve safety outcomes and help prevent patient harm. http://patientsafety.pa.gov/
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