Hand and Upper Extremity

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Hand and Upper Extremity Focus Group 2009
Dana Moulton, OT CHT Lisa Perrone,OTR,CHT Pam
Harrell, OTR,CHT Facilitator
Skip Brown, OTR,CHT Peggy Haase, OTR,CHT Joanna
Hearington, RN
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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

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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

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Patient Education Handouts Developed

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

5
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.
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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

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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, deQuervains 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

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Accessing Handouts and Protocols

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

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Next Steps

• Project for 2010 identified
• Extensor tendon management
• Continue to develop patient education tools

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Thank You!!!Questions???