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IMPROVEMENT IN ACTION
Stroke Arm Pillowcase
Up to 70% of stroke survivors have reduced or no functional use of their arm following their stroke. This can lead to pain, shortening of muscles, pressure problems and respiratory complications. Clinical guidelines recommend achieving a good arm position for treating the stroke arm.
The research literature is not clear on the correct position the arm should be placed and this has resulted in inconsistency in the positioning of the stroke arm in clinical practice.
To establish the correct position there was a review of the literature and clinical guidelines. The details within the Scottish Intercollegiate Guidelines Network (SIGN, 2010) stated a consensus view of the correct position and this informed the development of a five-point best practice guide.
The Stroke Arm Position Tool
The knowledge of this work and in conjunction with patients the idea of the stroke arm pillowcase was developed. Generally, clinicians recommended the arm is placed on standard pillowcase and pillow to support the correct position. The stroke arm pillowcase provides an illustrated and written instructions to promote the correct position.
Solent NHS Trust Dragons Den provided the opportunity to design, register and trial the stroke arm pillowcase. 70 pillowcases where produced and trialled across the region with stroke survivors who were unable to lift their arm to their mouth. The trial demonstrated an improvement in the consistency of achieving the five points of the Stroke Arm Position Tool.
The Stroke Arm Position Tool has 5 points which is recorded through observing the arm position, as a Yes/No scale. With a normal pillow, patients average was 2.8 out of 5 and on using the stroke arm pillowcase the average was 3.8 out of 5 points.
The Stroke Arm Pillowcase in conjunction with the Stroke Arm Position Tool provides a consistent and purposeful promotion to the staff, patients, and their carers on the correct position to place the arm. The long-term aim is to increase the availability of the Stroke Arm Pillowcase to more stroke survivors.
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