Management of adults with a tracheostomy: An international survey of speech-language pathologists' practice.

Purpose: Speech-language pathologists are specialists in communication, swallowing, and weaning as core members of the multidisciplinary tracheostomy team. Inconsistent tracheostomy care is known to result in staff and patient frustration, delayed intervention, and patient harm. Little is known about international speech-language pathology tracheostomy practices.

Method: This global survey explored training, clinical practices, perceived knowledge, skills and roles, as well as barriers to change and successes. Questions consisted of likert scale and open-ended questions. 1 458 Speech-language pathologists completed the survey representing six continents and 52 countries.

Result: Overall, speech-language pathologists were confident in their knowledge and skills. Tracheostomy teams were viewed as a key facilitator of best care. Access to Flexible Endoscopic Evaluation of Swallowing was variable and considered valuable by all. Four key themes emerged: Knowledge and skills, roles and multidisciplinary tracheostomy team relationships, written documentation and protocols, and access to resources. Multidisciplinary tracheostomy team relationships and being valued as a professional were the most common concerns. Speech-language pathologists had a plethora of successes to share that had changed their workplace.

Conclusion: This survey shows speech-language pathologists are aligned internationally with common purpose and values. Speech-language pathologists voiced challenges in multidisciplinary tracheostomy team relationships, standardising practice, and resourcing. Benchmarking is the first step to targeted change and we hope this will support and empowerclinicians to continue to innovate tracheostomy practice.