Factors influencing manual wheelchair abandonment for these participants were consistent with findings from the literature concerning dissatisfaction and abandonment of assistive technology. For these three individuals the lack of experience in wheelchair use and selection, the functional limitations encountered with the design of the wheelchair and the manner and timing of the prescription process combined to lead to dissatisfaction and ultimately abandonment. Suggestions for changes to wheelchair prescription practices were made.

Wheelchair prescription for individuals with a spinal cord injury is a highly complex and challenging clinical intervention. Evidence exists that successful outcomes are not always achieved for the wheelchair user and that therapists are experiencing increasing pressure to be accountable for and to justify their wheelchair prescription practice. This paper describes the process of establishing an evaluation of wheelchair prescription practices by occupational therapists in a spinal injury rehabilitation unit in South Australia. The evaluation process centred on the development of standards of practice to monitor performance and led to improvements in: (i) service delivery practices; (ii) wheelchair user participation; and (iii) accountability and justification of service delivery. Steps taken to develop the standards of practice to monitor performance and the benefits and limitations of the evaluation are described. K E Y W O R D S wheelchair prescription, standards of practice, spinal cord injury.

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