WRIST SPLINT COMPETENCY

Transcription

1 WRIST SPLINT COMPETENCY Aim To understand when and why a Roylan wrist splint is used To know when not to use the splint and when to stop using it To know how to apply the Roylan wrist splint and what to check for When and why a Roylan wrist splint is used The hand, fingers, thumb and wrist can become tight as a result of neurological disease processes such stroke, multiple sclerosis, other neurological conditions or following a head injury. As a result the muscles controlling the hand, wrist and fingers can receive altered messages from the brain and the fingers can tighten into a flexed position and may dig into the palm. The wrist may also drop or be pulled into a flexed position. As a result of tightness in the fingers and thumb and a dropped wrist it can become difficult to clean the palm and in between the fingers and thumb. The mal-alignment of a dropped wrist can be painful and the wrist can tighten into this position making it difficult to get clothing onto the arm. The Roylan wrist splint is used to maintain the fingers and thumb from digging into the palm and maintain the position of the wrist helping to reduce pain in the wrist joint. Contraindications to using the Roylan wrist splint and when to stop using it Consult with the physiotherapist or nurse if any of the following are noted on the hand, palm or fingers. Abnormal red areas of skin New wounds / dressings A significant increase in swelling or bruising The service user reports pain or injury in the wrist, hand, fingers or thumb since the last treatment. The wrist, hand, fingers or thumb have become tighter in the muscles or joints and it seems more difficult to get the splint on.

2 How to apply the Roylan wrist splint and what to check for Procedure 1. Check the plan for variation, which hand the splint is to be applied to, when the splint is to be applied, duration it is to be used for, the number of times it is to be applied in the day, who should take it off and care of skin before and after use. 2. Explain what you are going to do and check for contraindications to using the Roylan wrist splint. 3. Position of the Service User the Roylan wrist splint can be applied in any comfortable position for the service user. 4. Position of the Rehabilitation Assistant any comfortable position close to the service users hand and arm. 5. Apply the Roylan wrist splint as per the photographs and instructions in Figure 1 to Figure Advise the Service User how long they should wear the splint for and that the straps will feel firm across the back of the hand and arm but should not cause any pain or significant discomfort to them. If it does they should tell a member of the nursing team or a therapist or RA. 7. Document in the notes. 8. Feedback to the Registered Practitioner who has allocated the task regarding how the service user did. Inform the nursing staff that the person is using the splint and that may need to remove the splint if the service user reports any pain or significant discomfort.

3 Application of Roylan Wrist Splint Figure 1. Place the hand on top of the splint, with the thumb through the hole and the fingers in between the felt strips. Figure 2. Secure the white Velcro straps around the back of the hand and the lower forearm. Figure 3. Secure the brown felt strip by taking it underneath the finger section of the splint, over the sheepskin block then back around and over the fingers to secure it with the Velcro.

4 SUPERVISED TASKS/EXERCISES CARRIED OUT BY REHABILITATION ASSISTANT COMPETENCIES NAME: TAUGHT MODELLED COMPETENT RT11 WRIST SPLINTS DATE DATE DATE 1 Read plan and identify aim and any specific instructions 2 Demonstrate knowledge of: i. When and why a Roylan wrist splint is used ii. Contraindications to use and when to stop using the splint 3 Give a verbal explanation of what you are going to do to the service user and gain their consent 4 Check for contraindications to use 5 Assist the service user into the correct position to apply the splint as per the plan 6 Position of the Rehabilitation Assistant relative to the service user 7 Apply the splint 8 Advise the service user about:- i. How the splint should feel ii. How long to wear the splint iii. What to in the event of significant discomfort 9 Documentation 10 Feedback to Registered Practitioner

5 RT11 WRIST SPLINTS DATE DATE DATE Sign and date when achieved Signature of Learner Signature of Assessor Date of review