UK survey of clinical consistency in tracheostomy management

McGowan, Susan L., Ward, Elizabeth C., Wall, Laurelie R., Shellshear, Leanne R. and Spurgin, Ann-Louise (2014) UK survey of clinical consistency in tracheostomy management. International Journal of Language and Communication Disorders, 49 1: 127-138. doi:10.1111/1460-6984.12052

Author McGowan, Susan L.
Ward, Elizabeth C.
Wall, Laurelie R.
Shellshear, Leanne R.
Spurgin, Ann-Louise
Title UK survey of clinical consistency in tracheostomy management
Journal name International Journal of Language and Communication Disorders   Check publisher's open access policy
ISSN 1368-2822
Publication date 2014
Year available 2013
Sub-type Article (original research)
DOI 10.1111/1460-6984.12052
Volume 49
Issue 1
Start page 127
End page 138
Total pages 12
Place of publication Oxford, United Kingdom
Publisher John Wiley & Sons
Collection year 2014
Language eng
Subject 3616 Speech and Hearing
3310 Linguistics and Language
1203 Design Practice and Management
Formatted abstract
Background: Many speech and language therapists (SLTs) work with patients who have a tracheostomy. There is limited information about their working practices and the extent to which recent publications and research have influenced the speech and language therapy management of the tracheostomized patient.

Aims: This study reviews the current patterns of clinical practice for SLTs in the management of adult tracheostomized patients in the UK.

Methods & Procedures: An online questionnaire was completed by 106 SLTs with prior experience in tracheostomy management. The information from this was explored to determine patterns of practice across various areas of speech and language therapy tracheostomy management including clinical roles and responsibilities, management of communication disorders, and assessment and management of dysphagia and decannulation. These clinical patterns were then examined with respect to the current literature, emerging patterns in evidence-based practice and national practice guidelines.

Outcomes & Results: The results indicate a moderate to high level of clinical consistency in the majority of areas evaluated across the scope of tracheostomy management in speech and language therapy. Consistency in practice areas such as increased utilization of instrumental assessments and conservative use of the Modified Evans Blue Dye Test indicate clinical application in line with current research. Limited clinical consensus or inconsistencies in evidence-based services were identified in aspects of practice that are supported by conflicting or emerging research evidence. Such areas include involvement in cuff deflation regimes, adoption of specific decannulation procedures and participation in multidisciplinary team management.

Conclusions & Implications: SLTs in the UK provide a moderate to high level of consistent practice in tracheostomy management. This study identifies areas of tracheostomy management that require further research in order to establish clinical practice guidelines and to address discrepancies between research evidence and clinical implementation.
Keyword Adults
Speech and language therapy
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 20 August 2013.

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
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