Best Practices, Ethics, References Flashcards
Sections of best practice guidelines
Client intake
Clinical visual screen
Clinical physical assessment
Clinical cognitive perceptual screening
Behind the wheel evaluation
Behind the wheel training/intervention
Vehicle and equipment assessment for drivers
Vehicle and equipment assessment for passengers
Documentation
Prescription/equipment recommendation form
Final fitting
Licensing
Quality improvement
Components of client intake best practice guidelines
-Determine the client‘s medical history
-Determine the clients current medical status
-Assess the clients communication needs
-Obtain all required consents – release of records, notice of privacy practices, medical consent from treating physician, etc.
-determine clients current medications
-Assess clients driving history
– Assess clients license status
– Determine the clients driving goals
– Determine the clients vehicle availability
– Determine the clients function for daily living tasks
Components of clinical visual screen best practices
– Determine the clients visual history
– Determine the clients visual acuity
– Assess the clients functional field of vision
– Screen for ocular motor abilities and other visual skills
Components of clinical physical assessment best practice guidelines
– Determine if the clients ROM is sufficient to operate vehicles controls
– Determine if the client strength is sufficient to operate vehicles controls
-Determine if clients hand strength is sufficient to operate vehicles controls
– Determine if client sensation is sufficient to operate vehicles controls
-determine if clients proprioception is sufficient to operate vehicles controls
– Determine if clients coordination is sufficient to operate the vehicles controls
– Assess clients muscle tone as it relates to operation of vehicle controls and determine presence of abnormal reflexes
– Determine clients mobility status
– Assess client static and dynamic valance
-determine clients use of orthotic or prosthetic devices
– Determine clients transfer skills – including mobility device storage
– Determine if clients reaction time is sufficient to operate vehicles controls
– Educate client regarding performance on physical assessment an impact on driving safety or mobility issues
Components of cognitive perceptual screening best practice guidelines
– Determine clients pass and current medical history and diagnosis that may underline or contributed to cognitive and permit
– Screen for presents and level of cognitive impairment
– Determine the clients level of self-awareness
– Determine appropriate intervention to address clients needs related to cognitive impairment in the context of driving
– Determine need and frequency of reassessment of client for progressive conditions
– Determine presents and level of visual perceptual impairment in client
– Determine, based on severity of cognitive/perceptual deficit whether or not on road assessment or continued services are indicated
Components of behind the wheel evaluation best practice guidelines
– Assess appropriateness of evaluation vehicle and/or equipment to meet clients evaluation needs
– Assess clients ability to enter an exit driver station
– Assess clients ability to stow, secure, and retrieve any existing mobility aids
– Assess clients ability to obtain and maintain an appropriate driving position
-assess clients ability to satisfactorily operate primary OEM controls
-assess clients ability to operate secondary OEM controls -assess when stationary and in motion
– Assess clients driving performance and progressively complex traffic/roadway conditions and weather conditions similar to those he would normally encounter
– Determine an appropriate graduated process for the client evaluation
– Assess impact of cognitive/perceptual, behavioral, and visual limitations on safely performing all driving tasks in the conditions encountered
– Assess safe use of any necessary adaptive driving equipment
– Assess for potential for improved safety with use of equipment and/or compensatory strategies
– Assess the impact or potential for impact of fatigue
-Assess appropriateness of current vehicle and determine if need a vehicle change
-assess appropriate equipment needs
– Determine outcome and options and review them with client/family
Adequate visual ellipse
Level should be close to the inferior border of rearview mirror as possible
Components of behind the wheel training/intervention best practice guidelines
– Set goals based on clients functional abilities
– Provide training that supports safe driving performance and client specific driving goals
– Provide training in a variety of conditions and environments
– Just clients goals as needed(3–4 rides without progress towards dated goals may require a change in intervention or equipment, referral to a specialist, or counseling on driving cessation)
Vehicle and equipment assessment for drivers best practice guidelines
– Determine funding source for driving eval, training, adaptive equipment
– Determine whether client has completed a clinical assessment
– Assess the clients ability to enter/exit current vehicle and transport any required mobility aids- determine if client should remain seated in mobility aid to enter/exit vehicle
– Based on industry norms, current knowledge of OM vehicles, available structural modifications determine most appropriate structural modification configuration and/or ingress options for client
– Determine clients ability to obtain an appropriate driving position
– Determine how the client will activate the gas and break
– Determine need for adapted or secondary switches and complementary accessory switches
– Determine how client will steer the vehicle
– Determine clients key/ignition activation skills
– Ensure the clients ability to obtain aid in emergency situation
– Ensure vehicles compliance with existing standards and guidelines
– Determine replacement vehicle options with the client
– Know and utilize resources to obtain adaptive equipment
-Provide pertinent information regarding local mobility equipment dealers
– Advise and assess client in meeting regulatory requirements of licensing agency for driving with adaptive equipment
– Ensure other drivers modified vehicle understand mechanics of the adaptive equipment

Components of vehicle and equipment assessment for passengers best practice guidelines
– Determine whether passenger can safely enter an exit vehicle
– Determine passenger and family members ability to safely Stowe, secure, retrieve all pertinent mobility aids
– Determine whether the client who uses a wheelchair will remain in that wheelchair during travel
– Assess vehicles capability for wheelchair/scooter transport
Components of documentation best practice guidelines
– Maintain written and electronic records of all services provided, while respecting clients confidentiality
– Release the documentation with respect to clients privacy
– Follow records retention guidelines
Components of prescription/equipment recommendation form best practice guidelines
-generate a comprehensive report that includes all pertinent findings from various assessments and evaluations
-base prescription/equipment recommendation form contents on clients actual performance in vehicle and with equipment functionally equivalent to that necessary for safe driving performance
– Make prescription/recommendation form as complete and specific as possible
– Provide copies of prescription/recommendation form to client and other parties as necessary
Components of final fitting best practice guidelines
– Ensure that recommendations in the prescription/equipment recommendation form have been followed
– Ensure clients functioning is optimal following any modifications performed and or equipment installed per prescription/equipment recommendation form
– Provide follow-up training as necessary
Components of licensing best practice guidelines
– Be knowledgeable about state licensure requirements for establishment of a driving program and provision of driver training services
-assist clients in Meeting State driver licensing requirements relevant to their particular situation
Components of quality improvement best practice guidelines
– Consult the document “spectrum of driver services”
– Join and maintain membership in ADED
-seek out relevant resources for continuing education
– Stay current with industry changes that may affect my ability equipment prescriptions and recommendations
– Develop a network of driver rehabilitation professionals
– Pursue specialty certification as a driver rehab specialist
– Establish a program based quality improvement system
