Resting splint research splint information charlie laver

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BAOT/COT Specialist Section Rhuematology Conference 2010

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Resting splint research splint information charlie laver

  1. 1. c. Hammond, Mellson, Laver 1 Resting Splint Survey – NW COTSS Rheumatology Group Survey of Information given to support the provision of resting splints and Focus Group results Jo Mellson1, Alison Hammond1 Charlie Laver2 Centre for Health, Sport & Rehabilitation Research, University of Salford1 ICATS, Pennine MSK Partnership2
  2. 2. c. Hammond, Mellson, Laver 2 Aim of study  To investigate current practice amongst group members related to the provision of NRS:  Patient instructions regarding splint wear  Patient instructions regarding splint care  Exercise provision
  3. 3. c. Hammond, Mellson, Laver 3 Response Rate  24/ 35 OTs replied (69%)  79% of respondents made splints  Respondents (n=19)  Majority of sample Band 7 OT’s  13 out of the 19 respondents provided the instruction sheets they give to patients when submitting questionnaire
  4. 4. c. Hammond, Mellson, Laver 4 1. What information do you give to patients about wearing their splint? Increase time wearing splint to ensure tolerance before wearing all night 15 Wear at night 10 If unable to tolerate at night, wear in evening 8 If provide with 2 splints, wear one at a time 7 Complete hand exercises on removal of splint 6 Check skin for problems on removal of splint 6 Wear only when resting 5 Wear as necessary to relieve pain or swelling 4
  5. 5. c. Hammond, Mellson, Laver 5 Verbal or written reasons for supplying splint given to patient Total 10 Decrease pain 5 Prevent further deformity 5 Decrease swelling/inflammation 5 Increase hand function 3 Maintain good hand position 2 Reduce pins and needles 2 For rest 2 To stabilise joints 1
  6. 6. c. Hammond, Mellson, Laver 6 2. What instructions do you give about care of the splint? Splint care Free text Sheets Wash in warm water 16 13 Avoid direct heat 16 13 Do not alter 9 9 Washing straps 3 3 Keep away from the dog 1
  7. 7. c. Hammond, Mellson, Laver 7 3. What instructions do you give about precautions? Physical precautions Free text (19) Instruction Sheets (13) Pressure 11 8 Changes in skin colour 10 10 Increased pain 9 5 Skin irritation 9 6 Pins and needles 8 6 Swelling 7 7 Numbness 5 5 Blisters 4 4 Altered sensation 3 3 Joint stiffness 2 2 Temperature changes; rash; marking; poor fit; uncomfortable 1 1
  8. 8. c. Hammond, Mellson, Laver 8 4. Do you routinely teach patients hand exercises when providing resting splints?  Yes = 13 (+1 if not taught already)  ROM exercises = 14  Strength exercises= 5  No = 4  OT does not provide the service = 2  Refer to PT for hand exercises= 2
  9. 9. c. Hammond, Mellson, Laver 9 Focus Group recommendations  The focus group was made up of 5 experienced Rheumatology Occupational Therapists.  Aim:  To develop guidelines for provision of a resting splints  To develop a protocol document for provision of resting splints for junior staff.  To develop guidelines for information that should be supplied to patients
  10. 10. c. Hammond, Mellson, Laver 10 Focus Group  Agreed:  Written information is essential  Should include:  Reasons for provision of splint  Precautions  Splint Care  Splint wear regimen
  11. 11. c. Hammond, Mellson, Laver 11
  12. 12. c. Hammond, Mellson, Laver 12 Things to be mindful of…  Small sample group.  Sample group from same area of the country.  Questionnaire does not extract all the reasoning behind why OT’s practice in the way they do.
  13. 13. c. Hammond, Mellson, Laver 13 Issues raised to think about  How do you position your splints?  Is midline a position that you have used?  What material do you use?  Is it the most appropriate for the splint?  What is on your instruction sheet?  Is it more focused on precautions rather than reasons?
  14. 14. c. Hammond, Mellson, Laver 14 Next steps 1. Explore use of compression gloves in a further questionnaire – ongoing collation 2. Recommend guidelines for RS [and compression glove] provision based on research and expert opinion 3. Recommend standard splint instructions 4. Publish results
  15. 15. c. Hammond, Mellson, Laver 15 Thank you!  To all members of North West COTSS- Rheumatology for taking the time to:  Contribute to methodology, responses and focus group involvement.  Engagement in debate and contribution to consensus for RS provision.

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