Ms Nicole Alexander1
1Royal Children’s Hospital Melbourne, Parkville, Melbourne, Australia
Background:Burns positioning and splinting is important for oedema control, protecting surgical intervention, maintain joint range of motion and prevention of contractures (Kolmus et al. 2014). Positioning can be challenging due to surgical restrictions, medical stability and individual patient factors. In the paediatric setting, positioning is further complicated by children not possessing cognitive reasoning to aid compliance (Dewey, Richard, Parry, 2011). Leblebici et al. (2006) investigated the long term impacts of contracture on quality of life and found contractures impact physical function, bodily pain and vitality. An admission of a complex paediatric burn patient highlighted some position and splinting communication challenges in our tertiary paediatric hospital and a decision was made to review methods of communication.
Methods:Nursing staff were surveyed across the paediatric intensive care and surgical unit to explore barriers to positioning and suggestions to improve communication charts. After compiling the survey results, positioning charts are currently being reviewed and altered in response to feedback and commonly noted themes through our practice. The new positioning charts are hoped to be implemented for trial in June 2018. A follow up survey will be completed to assess the effectiveness of new positioning charts.
Outcomes:The new positioning chart will be discussed at the conference and we plan to have the results of the follow up survey to present at the conference.
Discussion:It is hoped that by collecting feedback directly from the staff involved in the interpretation of positioning charts that clarity and compliance will be improved.
Dewey, WS, Richard, RL, Parry, IS. (2011) Positioning, Splinting and Contracture Management. Physical Medicine and Rehabilitation Clinics of North America, vol. 22, pp. 229-247.
Kolmus, A, West, S, Salway, J, Darton, A. 2014, ‘Splinting and Positioning’ in D.Edgar (ed) Burns and Trauma Rehabilitation: Allied Health Practice Guidelines,Lippincott Williams and Wilkins, Philadelphia, PA, pp. 151-174.
Leblebici, B et al. (2006). Quality of Life After Burn Injury: The Impact of Joint Contracture. Journal of Burn Care and Research, vol.27, pp. 864-868.
Nicole is senior clinician for burns and plastics at The Royal Children’s Hospital in Melbourne.