Hand and Upper Extremity
Focus Group
2009
Skip Brown, OTR,CHT
Peggy Haase, OTR,CHT
Joanna Hearington, RN
Dana Moulton, OT CHT
Lisa Perrone,OTR,CHT
Pam 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
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Splint instructions
Desensitization home program
Cryotherapy
Contrast bath home program
Discharge home instructions
Home Exercise Programs Created
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.
• Elbow and wrist
A/PROM
• Digital A/PROM
• Tendon gliding
exercises
• Thumb A/PROM
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
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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???