Competencies for advanced clinical practice (ACP) hand therapists in first-line management of closed hand fractures: Results of a United-Kingdom (UK) stakeholder consensus study

Abstract

Introduction

In the United Kingdom [UK], Advanced Clinical Practice (ACP) roles are being developed to improve access to high-quality patient care, where healthcare services are struggling to meet steadily increasing service demands. Increasingly, ACP hand therapists are assessing and treating acute closed hand fractures. However, the knowledge and skills required of these roles has not been identified or standardised.

Methods

Consensus recommendations were developed from an expert panel of medical doctors and hand therapists using an electronic Delphi process. Participants were recruited from purposive and snowball sampling. Delphi questions were developed from a literature review and clinician survey and included rating of items open text responses. Consensus was defined as ≥75% agreement. Summary feedback was provided after each round.

Results

There were 20 panellists (12 medical doctors and 8 hand therapists), of which 18 (90%) completed all rounds. 23 competencies were consistently identified as very important; there was less agreement on how to evidence these competencies.

Conclusion

These findings can be used to develop ACP hand therapist roles and provide a framework to guide individual therapists to base their own learning and development. They underpin safe, efficient and costeffective patient care.