Resting splint research splint information charlie laver

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

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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

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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

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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

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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

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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

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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; uncomfortable1 1

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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

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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

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Focus Group

Agreed:

Written information is essential

Should include: Reasons for provision of splint

Precautions

Splint Care

Splint wear regimen

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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.

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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?

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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

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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.