PMID- 26472606
OWN - NLM
STAT- MEDLINE
DCOM- 20161020
LR  - 20161230
IS  - 0736-4679 (Print)
IS  - 0736-4679 (Linking)
VI  - 50
IP  - 2
DP  - 2016 Feb
TI  - An Educational Intervention to Improve Splinting of Common Hand Injuries.
PG  - 228-34
LID - 10.1016/j.jemermed.2015.08.011 [doi]
LID - S0736-4679(15)00901-4 [pii]
AB  - BACKGROUND: Hand trauma is a top presenting complaint to hospital emergency
      departments (EDs) and can become costly if not treated effectively. The
      cornerstone for initial management of the traumatized hand is application of a
      splint. Improving splinting practice could potentially produce tangible benefits 
      in terms of quality of care and costs to society. OBJECTIVES: We sought to
      determine the following: 1) whether the present standard of ED splinting was
      appropriate and 2) whether a strategically planned educational intervention could
      improve the existing care. METHODS: We used a pre- and postprospective
      educational intervention study design. In the preintervention phase, patients
      referred to our hand clinic were assessed for injury and splint type. Splinting
      appropriateness was evaluated according to a predetermined hand surgeons' expert 
      consensus. Next, an educational intervention was targeted at all ED staff at our 
      institution. Postintervention, all patients were again evaluated for splint
      appropriateness. A follow-up evaluation was performed at 1 year to see the
      long-term effects of the intervention. RESULTS: The most common mechanism of
      injury of referred patients was falling (35%), and the most frequent injury was
      metacarpal fracture (40%). Splint appropriateness increased significantly
      postintervention from 49% to 69% (p = 0.048). At follow-up after 1 year,
      splinting appropriateness was 70% (p = 0.041). CONCLUSION: Appropriate hand
      splinting practice is essential for hand trauma management. Our results show that
      an educational intervention can successfully improve splinting practice. This
      quality of care initiative was low-cost and demonstrated persistence at 1 year of
      follow-up.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - McEvenue, Giancarlo
AU  - McEvenue G
AD  - University of Toronto Hand Program, Toronto Western Hospital, University Health
      Network, Toronto, Ontario, Canada.
FAU - FitzPatrick, Fiona
AU  - FitzPatrick F
AD  - University of Toronto Hand Program, Toronto Western Hospital, University Health
      Network, Toronto, Ontario, Canada.
FAU - von Schroeder, Herbert P
AU  - von Schroeder HP
AD  - University of Toronto Hand Program, Toronto Western Hospital, University Health
      Network, Toronto, Ontario, Canada.
LA  - eng
PT  - Journal Article
DEP - 20151021
PL  - United States
TA  - J Emerg Med
JT  - The Journal of emergency medicine
JID - 8412174
SB  - IM
MH  - Adult
MH  - Emergency Medicine/*education/*standards
MH  - Female
MH  - Follow-Up Studies
MH  - Hand Injuries/*therapy
MH  - Humans
MH  - *Inservice Training
MH  - Interrupted Time Series Analysis
MH  - Male
MH  - Middle Aged
MH  - Quality Improvement
MH  - Splints/*standards
MH  - Time Factors
MH  - Young Adult
OTO - NOTNLM
OT  - education
OT  - hand
OT  - intervention
OT  - splinting
OT  - trauma
EDAT- 2015/10/17 06:00
MHDA- 2016/10/21 06:00
CRDT- 2015/10/17 06:00
PHST- 2015/02/28 00:00 [received]
PHST- 2015/07/09 00:00 [revised]
PHST- 2015/08/13 00:00 [accepted]
PHST- 2015/10/17 06:00 [entrez]
PHST- 2015/10/17 06:00 [pubmed]
PHST- 2016/10/21 06:00 [medline]
AID - S0736-4679(15)00901-4 [pii]
AID - 10.1016/j.jemermed.2015.08.011 [doi]
PST - ppublish
SO  - J Emerg Med. 2016 Feb;50(2):228-34. doi: 10.1016/j.jemermed.2015.08.011. Epub
      2015 Oct 21.