The diagnosis should not be used to describe patients with traumatic injuries, critical illness myopathy, or any reversible condition. 

• Complete inability to move extremities, no history of spinal cord injury or damage, a history that supports an inability to move independently or provide self-care, and collaborative documentation from other healthcare staff (nursing, PT, etc.). 
• Two key components of the Braden Scale used by nursing can be indicators that functional quadriplegia applies 
  • Activity-this scores the patient’ level of activity 
  • Mobility-this scores the patient’s ability to reposition independently 
• The Braden Scale components are scored 1-4 with the lowest score being indicative of a greater degree of impairment.  
  • Example: If the patient’s Activity and Mobility scores are 1 each, this patient needs investigation for functional quadriplegia. 

• Functional quadriplegia should be considered when reviewing charts for patients who have diagnoses of severe/end stage dementia, or advanced neurodegenerative disorders such as MS, ALS, cerebral palsy, or Huntington’s disease. 

• Always review the nursing assessments focusing on the functional assessment. Look for clues such as bed mobility and inability to perform ADLs. 

• Patients with documented contractures will likely have functional quadriplegia. 

• Always read PT notes, if available, before placing a query to validate mobility status. 

• Some contributing conditions leading to functional quadriplegia are morbid obesity, chronic respiratory conditions, arthritis, and joint disease. 

• Ensure the underlying disease process causing the functional quadriplegia is documented. 

• Review the record for any complications associated with immobility, such as pressure injuries, aspiration, and malnutrition.