Hemiplegic Shoulder Pain Prevention: A Collaborative Approach With Nursing and Occupational Therapy in Acute Care

Hemiplegic shoulder pain is a common problem after stroke. Prevention is the ideal management strategy for this shoulder pain type. However, many healthcare providers are not trained in management techniques for HSP. The nursing staff is the primary care provider in the acute care hospital. Therefore, the Arm in Arm project, a quality improvement initiative, was developed to improve acute care nursing staff's clinical practice for implementing the recommended positioning and handling techniques into routine care for patients with arm hemiplegia after stroke. During this 10-week project, occupational therapy and the nursing staff worked collaboratively to change practices in positioning and handling techniques with patients with arm hemiplegia. A self-developed observation checklist monitored the nursing staff's adherence to techniques. After ten weeks, the nursing staff's adherence to positioning techniques in routine care increased from 12% to 71%, and their adherence to handling techniques increased from 50% to 91%.