Development of a Screening Tool for Safe Wheelchair Seating

Objectives: Most elderly nursing home residents who need wheelchairs are not being assessed individually to ensure proper prescription for safe and effective mobility. This study evaluated the use of a new screening tool, the Resident Ergonomic Assessment Profile for Seating (REAPS). Methods: This descriptive study design examined the reliability and validity of the REAPS in a Veterans nursing home. Fifty subjects (mean age = 78) were screened by four raters and an independent criterion expert. Test-retest reliability was performed on 18 subjects. Other measures included resident discomfort, mobility, and posture. Results: Although interrater agreement varied according to the items on the REAPS, ratings suggested reasonable agreement among various raters and the seating expert, and moderate overall sensitivity. REAPS scores provided by the raters were positively correlated with expert opinion, as well as performance measures of mobility and head angle. Conclusions: The REAPS is intended to serve as a brief, easily administered screen to identify individuals in need of formal wheelchair seating evaluation. The results of this study suggest that, pending minor revisions, nursing home staff members with minimal instruction can use this tool to conduct this type of screening. Future development and research is warranted to explore the efficacy of the REAPS across long-term care settings in both VA and community facilities. Utilization of a revised version of the REAPS to identify wheelchair seating problems could have important policy and funding implications for the future.