position!statement:!! tracheostomy! management! · pdf file12.2.3 impact of the tracheostomy...

Click here to load reader

Post on 09-Jun-2018

214 views

Category:

Documents

0 download

Embed Size (px)

TRANSCRIPT

  • !

    !

    !

    The!New!Zealand!Speech/language!Therapists!Association!(NZSTA)!

    !!!

    Position!Statement:!!

    Tracheostomy!Management!

    !!!!!!!!!!!!!!!Copyright!!2015!The!New!Zealand!Speech;language!Therapists!Association!!!!!!!!Disclaimer:!To!the!best!of!The!New!Zealand!Speech;language!Therapists!Associations!(the!Association)!knowledge,!this!information!is!valid!at!the!time!of!publication.!The!Association!makes!no!warranty!or!representation!in!relation!to!the!content!or!accuracy!of!the!material!in!this!publication.!The!Association!expressly!disclaims!any!and!all!liability!(including!liability!for!negligence)!in!respect!of!use!of!the!information!provided.!The!Association!recommends!you!seek!independent!professional!advice!prior!to!making!any!decision!involving!matters!outlined!in!this!publication.!!!!

  • 1!

    Acknowledgements!!Working!party!Lucy!Greig!(lead)!Molly!Kallesen!Melissa!Keesing!Anna!Miles!Turid!Peters!Samantha!Scott!Katie!Ward!!!

    Speech!Pathology!Australia!for!sharing!Speech&Pathology&Australia.&(2013).&Tracheostomy&Management&Clinical&Guideline.&Melbourne:&Speech&Pathology&Australia.&with!members!of!the!New!Zealand!Speech;language!Therapists!Association.!!!Advisors!Karen!Brewer,!Speech;language!Therapist,!Te!Kupenga!Hauora!Maori,!Faculty!of!Medical!&!Health!Sciences,!The!University!of!Auckland.!!Erena!Wikaire,!Physiotherapist,!Te!Kupenga!Hauora!Maori,!Faculty!of!Medical!&!Health!Sciences,!The!University!of!Auckland.!!Reviewers!The!New!Zealand!Speech;language!Therapists!Association!Executive!Committee!The!New!Zealand!Speech;language!Therapists!Health!Leaders!Forum!!!Background+!!The!New!Zealand!Speech;language!Therapists!Association!(NZSTA)!identified!the!need!for!a!position!statement!and/or!clinical!guideline!for!speech;language!therapists!(SLTs)!managing!tracheostomy!patients!in!New!Zealand.!A!working!party!was!formed!to!determine!if!an!existing!clinical!guideline!from!one!of!the!Associations!Mutual!Recognition!Agreement!(MRA)!partners!or!any!other!international!sources!would!be!appropriate!for!use!in!the!New!Zealand!context.!The!working!party!identified!six!such!clinical!guidelines/position!statements.!The!Speech&Pathology&Australia&(2013)&Tracheostomy&Management&Clinical&Guideline.&Melbourne:&Speech&Pathology&Australia&was!deemed!the!most!comprehensive!document!for!NZSTA!both!in!terms!of!rigour!of!development!and!relevance!to!New!Zealand!SLTs.!!An!in;depth!review!of!this!guideline!was!conducted!to!identify!any!areas!that!needed!modification!in!order!to!assist!SLTs!working!in!New!Zealand!in!applying!the!guideline!to!their!practice.!These!modifications!and!additions!have!been!incorporated!into!this!position!statement.!!!

  • 2!

    Aim!!This!position!statement!aims!to!be!relevant!to!the!management!of!both!children!and!adults!with!tracheostomies!and!to!support!practice!across!the!breadth!of!services!of!New!Zealand!(i.e.!rural!and!urban,!community!and!hospital;based).!The!position!statement!and!the!supporting!documents!referenced!must!always!be!used!within!the!context!of!local!governance!(i.e.!the!clinicians/managers!own!organisation's!policies!and!procedures).!!!The+position+of+the+NZSTA!!It!is!the!position!of!the!New!Zealand!Speech;language!Therapists!Association!(NZSTA)!that!working!in!the!field!of!tracheostomy!is!within!the!scope!of!practice!of!speech;language!therapists.!!!The!NZSTA!endorses!the!use!of!the!Tracheostomy&Management&Clinical&Guideline&(Speech&Pathology&Australia,&2013)&as!the!overarching!guiding!document!for!its!members!working!in!the!field!of!tracheostomy.!!!This!guideline!should!be!interpreted!with!the!unique!New!Zealand!context!in!mind.!!As!health!professionals!working!in!New!Zealand!and!members!of!the!New!Zealand!Speech;language!Therapists!Association,!we!are!committed!to!upholding!the!Treaty!of!Waitangi!and!to!reducing!health!inequities.!Clinicians!utilizing!this!guideline!should!ensure!their!practices!are!culturally!appropriate!and!demonstrate!the!importance!of!holistic!views!of!health!and!wellbeing!that!include!physical,!mental,!social!and!spiritual!elements,!especially!with!persons!who!identify!as!Mori.!!The!amendments!and!additions!listed!below!provide!guidance!and!clarification!for!clinicians!applying!the!Tracheostomy!Management!Clinical!Guideline!(Speech!Pathology!Australia,!2013)!to!clinical!practice!in!New!Zealand.!! !

  • 3!

    Modifications/Amendments+to+the+Tracheostomy,Management,Clinical,Guideline,(Speech,Pathology,Australia,,2013)+for+the+New+Zealand+Context.!!Terminology!!

    " speech&pathologist&(SLP)!refers!to/is!interchangeable!with!speech2language&therapist&(SLT)!

    !" speech&pathology!refers!to/is!interchangeable!with!speech2language&therapy&or&

    speech&therapy!!

    " when!Speech&Pathology&Australia!is!used!in!a!sentence,!such!as!Speech!Pathology!Australia!supports!an!evidence!based!approach!to!assessment!and!management!in!the!area!of!tracheostomy,!Speech&Pathology&Australia!is!interchangeable!with!The&New&Zealand&Speech2language&Therapists&Association.!

    !" state/territory!is!interchangeable!with!national/district!

    !!Documentation+references!

    !" where!the&Speech&Pathology&Australia&Code&of&Ethics&(2010)!and/!or!Principles&of&

    Practice&(2001)&are!referred!to,&SLTs!working!in!New!Zealand!should!refer!to!the&NZSTA&Principles&and&Rules&of&Ethics&(2015)&and&NZSTA&Scope&of&Practice&(2012)!

    !" where!the!Speech&Pathology&Australia&Scope&of&Practice&(2003)&document!is!

    referred!to,!SLTs!working!in!New!Zealand!should!refer!to!the&NZSTA&Scope&of&Practice&(2012)&document.!

    ! !

  • 4!

    Guideline+amendments+by+section!!

    Page! Section!no.!

    !!Section! Amendment!!

    33! 15.4! Credentialing!&!Competency!

    Please!refer!to!your!own!organisational!policies!&!procedures.!These!sit!under!individual!employers!in!New!Zealand.!!Please!also!refer!to:!

    " NZSTA!Return!to!Practice!Policy!for!examples!of!appropriate!supervision!logs!and!competencies!documents!for!SLTs!extending!their!scope!of!practice!into!a!new!specialist!area.!

    38!! 16.1!! Education/!Professional!Development!

    Please!also!refer!to:!" The!NZSTA!Professional!Development!

    Policy,!2014!!! !

    Simulation!Training!for!Tracheostomy!Management!is!also!available!in!New!Zealand!through!The!University!of!Auckla[email protected]auckland.ac.nz!

    41! 19.8! Indemnity!cover!&!insurance!

    This!is!country;specific.!Please!refer!to!NZSTA!Indemnity!insurance!advice!http://www.speechtherapy.org.nz/page/about;slt/indemnity;insurance/!Please!also!check!with!your!employer!that!you!are!covered!for!the!scope!of!practice!that!you!are!undertaking.!

    42! 20! Future!directions!

    Research!into!the!effectiveness!of!Simulation!Training!for!Tracheostomy!Management!is!currently!being!conducted!in!New!Zealand!as!well!as!in[email protected]auckland.ac.nz!

    49! 22! Support!Groups!Patient!and!carer!!support!groups!

    Please!also!refer!to:!www.tracheykids.co.nz!www.makaton.org.nz!www.nzsl.vuw.ac.nz/signs!www.voicethruyourhands.org.nz!www.passy;muir.com!!

    51! 23! References! Please!also!refer!to:!Andreoli,!Steven!M,!Nguyen,!Shaun!A,!White,!David!R!(2010)!Feeding!status!after!pediatric!laryngotracheal!reconstruction.!Otolaryngology;Head!and!Neck!Surgery!143,!210;213!

    !! !

  • 5!

    !

    Related+documents+!!This! guideline! should! be! read! in! conjunction!with! the! New! Zealand! Speech;Language!Therapists!Association!core!documents!including:!!!

    " Tracheostomy! training! programme! for! therapists! working! with! adult! patients!(2013)!

    " NZSTA!VFSS!Guideline!(2011)!" NZSTA!Principles!&!Rules!of!Ethics!(2015)!" NZSTA!Scope!of!Practice!(2012)!" NZSTA!Professional!Development!Policy!(2014)!" Competency;based!Occupational!Standards!for!Speech!Pathologists!(5)!(2011)!" NZSTA!Full!Member!Return!to!Practice!Framework!(2015)!

    !!Review+!!This!position!statement! is! to!be!reviewed!every! five!years! following!Speech!Pathology!Australias!review!of!their!Clinical!Guideline.!The!review,!which!will!be!overseen!by!the!NZSTA!Executive!Council,!must!also!consider!if!the!externally!sourced!clinical!guideline!continues! to! be! suitable! for! NZSTA! members.! ! The! related! NZSTA! documents! listed!above!are!reviewed!every!five!years.!!!

  • Level 2 / 11-19 Bank Place T 61 3 9642 4899 [email protected] Melbourne Victoria 3000 F 61 3 9642 4922 www.speechpathologyaustralia.org.au

    The Speech Pathology Association of Australia Limited ABN 17 008 393 440

    Clinical Guideline

    TRACHEOSTOMY

    MANAGEMENT

    Copyright 2013 The Speech Pathology Association of Australia Limited

    Disclaimer: To the best of The Speech Pathology Association of Australia Limiteds ("the Association") knowledge, this information is valid at the time of publication. The Association makes no warranty or representation in relation to the content or accuracy of the material in this publication. The Association expressly disclaims any and all liability (including liability for negligence) in respect of use of the information provided. The Association recommends you seek independent professional advice prior to making any decision involving matters outlined in this publication.

  • Tracheostomy Clinical Guideline Copyright 2013 The Speech Pathology Ass