Hand and Upper Extremity Focus Group 2009 Skip Brown, OTR,CHT Peggy Haase, OTR,CHT Joanna...

Hand and Upper Extremity

Focus Group

2009

Skip Brown, OTR,CHTPeggy Haase, OTR,CHTJoanna Hearington, RN

Dana Moulton, OT CHTLisa Perrone,OTR,CHTPam Harrell, OTR,CHT Facilitator

Practice Tools Update

• Consistency between practices at VOI and VOCS

• Information provided to patients referred outside VUMC

• Patient education handouts• Basic ROM exercise handouts • Protocols last updated in 2005

Project Process – Patient Education Tools

• Reviewed all patient education and exercise handouts

• Developed a list of materials needed • Created exercise handouts with original

photographs and written instructions• Developed patient education handouts for home

programs and discharge instructions

Patient Education Handouts Developed

• Splint instructions• Desensitization home program• Cryotherapy• Contrast bath home program• Discharge home instructions

Home Exercise Programs Created

• Elbow and wrist A/PROM

• Digital A/PROM• Tendon gliding

exercises• Thumb A/PROM

Hold middle joint of your affected hand to prevent bending. Slowly bend end joint.Perform ____ sets per session. Peform ____ sessions a day.

Use unaffected hand to bend finger at all three joints.Hold _____ seconds. Perform ____ sets per session. Peform ____ sessions a day.

Project Process – Updating of Protocols

• Reviewed protocols developed in 2005• Utilized Rehabilitation of the Hand, Fourth

Edition and Diagnosis and Treatment Manual for Physicians and Therapists, The Hand Rehabilitation Center of Indiana

• All protocols were updated with input from VOI/VOCS hand therapists, hand practice RN

• Approved by Drs. Weikert, Watson and Lee

Hand Therapy Protocols

• Elbow – distal biceps repair, triceps repair, dislocation, lateral epicondylar debridement, radial head arthroplasty, ulnar verve transposition, olecranon ORIF, elbow release and total elbow arthroplasty

• Wrist – carpal tunnel, deQuervain’s release, ganglion cyst excision, distal radius ORIF

• Hand – crush injuries, fingertip injuries, tenolysis, trigger finger, MP/PIP arthroplasty

• Thumb – CMC arthroplasty

• Miscellaneous protocols – nerve repair, pain management, wound care

Accessing Handouts and Protocols

• Shared drive• VSMC folder• VOI therapy folder• Hand therapy folder

Next Steps

• Project for 2010 identified• Extensor tendon

management• Continue to develop

patient education tools

Thank You!!!

Questions???