Open Forum

Hello everyone, 

I am a clinical nurse educator working with my ambulatory orthopedics division to establish standardized training and ongoing competency in fiberglass cast application and removal. I would love to connect with others working in or with orthopedics teams to hear how these educational needs have been addressed elsewhere. 

In particular, I would love to hear which team members perform casting services (casting technologists, medical assistants, LPNs/RNs, etc), how or where these team members received their didactic and practical skills training (In-house? Outside experts?), and whether/how these skills are routinely monitored and assessed. Insights into any other aspect of casting skill acquisition or validation would also be greatly appreciated!

Thank you in advance for your time and attention,

Hi Heather

I am based in California and currently our nurses (depending on dept.) and ortho techs performs this task. It is outside of the scope of practice of the MA to perform any type of splitting that manipulates the extremities.  These skills are assessed annually during their competencies and as needed. The education is delivered by the educators. Comps are done in a live environment. We utilize Mosby's/Elsevier nursing skills & procedures and the American Academy of Ortho as resources. 

I am not much help here but our ortho clinic is small.  1 Physician and 1 PA.  They do all of their own casting currently. 

good morning! we did partner with our ortho service line on this topic. 

our outcomes were:

• MAs LPNs and RNs our org supports the following:

  • Cast, Application and Removal of
    •    Fiberglass
    •    Plaster    Simple fractures only.

    Pre and post-evaluation must be performed by the physician or APC.

    Physician or APC to determine if a cast shield should be utilized.

• There are 3 self paced modules the clinical staff must complete in HealthStream and then they complete the attached skills validation checklist as outlined.
• In our state, there is no specific verbiage prohibiting our MAs LPNs and RNs from performing these tasks; we also review CAAHEP, ANA, and professional organizations that are pertinent to the specialty along with school curriculum when evaluating what is determined in or out of scope. We have a decision tree that we utilize to help guide us on consistent decision-making as well. I hope this helps!

Attachment(s)

Casting Competency 11.16.22.docx   39 KB 1 version

Hi Heather!

We are currently having difficulty finding a place to train our ortho techs.  There used to be a school around us that offered the didactic portion, but the program has closed. We have investigated further and discovered that the American Society of Orthopedic Professionals (ASOP) have online training: Orthopedic Fracture Casting workshop, Bracing and Splinting Course.   

They are very easy to work with and very willing to share. We are currently working with them to develop peds specific training.