Factors influencing clinical consistency and variability in voice prosthesis management

Hancock, Kelli L, Ward, Elizabeth C, Burnett, Robyn A, Graciet, Peta K, Lenne, Priscilla J, MaClean, Julia C F and Megee, Felicity J (2017) Factors influencing clinical consistency and variability in voice prosthesis management. International journal of speech-language pathology, 1-11. doi:10.1080/17549507.2017.1353133

Author Hancock, Kelli L
Ward, Elizabeth C
Burnett, Robyn A
Graciet, Peta K
Lenne, Priscilla J
MaClean, Julia C F
Megee, Felicity J
Title Factors influencing clinical consistency and variability in voice prosthesis management
Journal name International journal of speech-language pathology   Check publisher's open access policy
ISSN 1754-9515
Publication date 2017-07-31
Year available 2017
Sub-type Article (original research)
DOI 10.1080/17549507.2017.1353133
Open Access Status Not yet assessed
Start page 1
End page 11
Total pages 11
Place of publication Abingdon, Oxfordshire United Kingdom
Publisher Taylor & Francis
Abstract Anecdotally it is recognised that management of tracheoesophageal speech (TES) post-laryngectomy varies between speech language pathology (SLP) services and clinicians. This study reviewed patterns of practice for TES management to examine patterns of practice and explore factors influencing variability.

A national survey was completed by SLP's from clinical services which manage TES. This online survey examined demographic and caseload information, initial voice prosthesis (VP) placement and procedures, VP cleaning and care recommendations, humidification management, equipment and service provision, and service delivery options at each site.

Lead clinicians from 34 sites (85% response rate) responded. Most clinical practice regarding initial VP insertion and management, as well as the timing and delivery of voice rehabilitation was highly consistent. Patient use of antifungal medications, TES and associated equipment provision, humidification management immediately post-surgery and some aspects of initial VP insertion were variable between services. The nature of the clinical setting, equipment funding and level of research evidence influenced variability in practice.

Variability exists in a number of aspects of practice across Australian services offering TES management. Sources of variability need to be addressed nationally to ensure there is consistent, quality care available for all patients.
Keyword clinical practices
service variability
speech language pathologist
tracheoesophageal speech
voice prosthesis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Health and Rehabilitation Sciences Publications
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Created: Wed, 15 Nov 2017, 13:30:06 EST