Improving Wrist Injury Pathways (I-WIP): a qualitative study
Research type
Research Study
Full title
Improving Wrist Injury Pathways (I-WIP): a qualitative study
IRAS ID
321650
Contact name
Benjamin Dean
Contact email
Sponsor organisation
Research Governance and Ethics Team, University of Oxford
Duration of Study in the UK
2 years, 0 months, 0 days
Research summary
Wrist injuries represent a considerable problem for both patients and the NHS. Around 70,000 patients per year in the UK attend hospitals with serious wrist pain after an injury, only to find that their x-ray is considered to be ‘normal’. The National Institute of Care and Health Excellence (NICE) advises that these patients should be given MRI (magnetic resonance imaging) scans early on, within 2 weeks. Early MRI gives patients the best care, by picking up the serious injuries requiring early treatment and by helping reassure those without serious injuries to get back to activities quickly. This saves the NHS staff time and money by reducing unnecessary clinic attendances. Although these benefits from early use of MRI scans, and the NICE guidance, are clear, we know from our recent national (UK) survey that only 11 of the 87 UK hospitals that we surveyed used MRI scans for these patients.
The gap between what the best evidence suggests and what happens in clinical practice is a complex issue that requires further investigation. To develop a complex intervention to address this problem, we need a far better understanding of the reasons why hospital services are currently unable to adopt the NICE guidance. In 2000, the UK Medical Research Council (MRC) established guidance for developing and evaluating complex interventions to improve the delivery of health care services. An important stage in developing complex interventions and improving care is to fully understand current pathways and the context of care. This qualitative study aims to develop a better understanding of wrist injury pathways, and their context, in the NHS. We aim to (1) understand the barriers to early MRI for painful wrists and (2) understand what is important to patients when being treated with a wrist injury.
REC name
South Central - Oxford A Research Ethics Committee
REC reference
23/SC/0118
Date of REC Opinion
19 Apr 2023
REC opinion
Further Information Favourable Opinion