Fournier Katia, Li Lily, Newington Lisa, Karantana Alexia, Bourke Grainne, Trickett Ryan W, Kennedy Donna L
Department of hand therapy, Charing Cross and St Mary's Hospitals, Imperial College Healthcare NHS Trust, Paddington, London, UK.
Department of Trauma & Orthopaedics, Imperial College Healthcare NHS Trust, London, UK.
Hand Ther. 2025 Jun 2:17589983251345406. doi: 10.1177/17589983251345406.
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.
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.
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.
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.
在英国，由于医疗服务难以满足不断增长的服务需求，高级临床实践（ACP）角色正在发展，以改善获得高质量患者护理的机会。越来越多的ACP手部治疗师正在评估和治疗急性闭合性手部骨折。然而，这些角色所需的知识和技能尚未得到明确或标准化。
通过电子德尔菲法，由医学博士和手部治疗师专家小组制定共识建议。参与者通过目的抽样和滚雪球抽样招募。德尔菲问题基于文献综述和临床医生调查制定，包括对开放式文本回复项目的评分。共识定义为≥75%的一致性。每轮后提供总结反馈。
有20名小组成员（12名医学博士和8名手部治疗师），其中18名（90%）完成了所有轮次。23项能力被一致认为非常重要；在如何证明这些能力方面的一致性较低。
这些发现可用于发展ACP手部治疗师角色，并提供一个框架，以指导个体治疗师进行自身的学习和发展。它们为安全、高效和具有成本效益的患者护理奠定了基础。
