10 Hints and Tips to Get the Most out of the Clinical Assessment

 

To enable the provision of appropriate equipment, and therefore achieve the desired seating objectives, a comprehensive assessment is essential.

It is impossible to prescribe specialist seating safely and correctly without a clinical assessment. Keep reading for ten top hints and tips from CareFlex’s Clinical Specialist, Rebecca Dunstall, on how to maximise the clinical assessment.

  1. Failing to prepare is preparing to fail; to get the most out of the assessment thorough planning is essential and certain factors should be considered:
  • Capacity and consent – relevant documents must be considered in advance.
  • Expectations – setting expectations will encourage compliance and successful joint working.
  • Environment – clinic setting if possible, ensuring comfort, dignity and safety throughout.
  • People present – multi-disciplinary assessment, including the client and support network.
  • Equipment – plinth, tape measure, slide gloves, goniometer, body crayons and wipes, camera and mirror.
  • Funding – an understanding of how the chair will be purchased can help set expectations.
  1. Apply a holistic approach throughout:
  • To increase compliance with equipment, the clinician must understand daily life for the individual.
  • It is critical that the chair meets the client’s expectations, and eases the demands on the support network, to ensure consistent use in line with the care plan.
  1. The subjective assessment, more commonly known as the information gathering part, can be more effective when completed with the client and their support network:
  • The main question that needs to be answered is “why does the client need a specialist seating system?”
  • It is also important to understand what the support network needs from the chair, as they are often relied upon by the client.
  1. The objective assessment, more commonly known as the physical assessment, is an opportunity for the clinician to determine the extent of any postural challenges:
  • The clinician will need to systematically work through the client’s body segments to understand whether they can be corrected or if they need to be accommodated by the chair.
  1. The client’s presenting sitting posture in their current equipment can help the clinician gain an understating of their preferred posture:
  • Palpating for weight distribution, with consent or in best interest, can give an indication of any postural challenges.
  • Any wear and tear to the client’s current seating can help confirm any asymmetries.
  1. Placing the client in supine allows the clinician to position them in an as midline neutral posture as possible:
  • This can aid the clinician in understanding how correctable the client’s body segments are.
  • It is important to determine this as it will influence the chair functions and accessories required.
  1. Using outcome measures can greatly enhance the clinical assessment:
  • Outcome measures will provide a baseline indication of the client’s posture.
  • Repeating the outcome measures when the client is positioned appropriately in specialist seating should confirm the improvement to their posture.
  • Outcome measures are also critical during reviews to ensure the chair continues to meet the objectives.
  1. Obtaining the correct chair measurements is a critical part of the assessment process:
  • Chair measurements will guide the chair set-up during provision.
  • Incorrect chair measurements will totally negate all the effort the clinician has made in meeting the clinical objectives.

 

  • Seat height – popliteal fossa to foot rest / floor
  • Depth – back of pelvis to back of knee
  • Width – width of pelvis
  • Arm rest height – seat to elbow
  • Seat back height – seat to back of head
  • Back angle – determined by hip flexion range
  • Leg rest angle – determined by hamstring muscles length

 

 

 

  1. The assessment process provides numerous opportunities to establish the client’s risk of developing a pressure injury:
  • The subjective assessment is a time to ask about any history of pressure injuries and relevant medical history such as medication, nutrition and continence.
  • The objective assessment can make apparent any current areas of skin integrity concerns.
  1. Clinicians are not alone in advocating for their client; contact CareFlex following the clinical assessment to complete the seating assessment jointly:
  • CareFlex are a team of highly skilled and extremely knowledgeable professionals, and seating assessors have many years combined experience of assessing for specialist seating.
  • They are experts in specialist seating; it must not be forgotten however that the clinicians are experts in clients. Both roles vary significantly but rely on the other for the chair provision to be a success.

For further learning on assessment skills, and to get a copy of The Encyclopedia of Specialist Seating, contact us to arrange a free CareFlex training lunch and learn session for you and your team. CareFlex also offer free training events all over the United Kingdom with the aim of increasing clinicians’ knowledge base, enhancing their skills and instilling confidence in the assessment and prescription of specialist seating.