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???