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- Title
Splinting for the prevention and correction of contractures: a retrospective audit.
- Authors
Pieterse, C.; Steed, A.; Ashford, S.
- Abstract
Introduction: Objectives were to identify areas for clinical and service development to improve Physiotherapists and Occupational Therapists adherence to the new Practice Guidelines published by the Association of Chartered Physiotherapists in Neurology (ACPIN) and the College of Occupational Therapy (COT) (COT, ACPIN 2015). Methods: The audit was carried out over a 3 month period. All patients discharged from a Level One inpatient tertiary neurological rehabilitation unit in 2013 who received splinting or casting were identified. Data was collected from clinical documentation and compared using the Clinical Audit Tool included within the Practice Guidelines. Results were recorded and analysed using Microsoft Excel™. Results: Of a total cohort of 95, 38 adults received a total of 65 interventions (54 upper limb, 11 lower limb). A total of 39 were custom made, with 26 pre-fabricated splints issued. Exploration of clinical reasoning identified 82% of splints were preventative, and 18% targeted correction. Based on information contained in clinical documentation, guideline statements were assigned for each intervention where possible. Statement number 13 (selective use of upper limb splints and not as routine practice) was the most prevalent. Remedial management of spasticity was considered in 74% of cases. Only 25% of interventions achieved goals set at baseline and in 10% no formal goals could be identified from the clinical documentation. Conclusion: The audit has identified weaknesses in clinical documentation, particularly goal setting and the review of specific outcome measures. The Practice Guideline Statements are useful to guide clinical reasoning and decision making but were difficult to audit retrospectively. New MDT clinical documentation to facilitate the clinical reasoning process through clear goals, outcomes and reviews is currently being trialled. A repeat audit is planned to complete the audit cycle.
- Subjects
ENGLAND; CONFERENCES &; conventions; CONTRACTURE (Pathology); OCCUPATIONAL therapy; SPLINTS (Surgery); COLLEGE of Occupational Therapists; BRITISH Association of Occupational Therapists
- Publication
British Journal of Occupational Therapy, 2016, Vol 79, p110
- ISSN
0308-0226
- Publication type
Article