A Consensus Statement for the Management and Rehabilitation of Communication and Swallowing Function in the ICU: A Global Response to COVID-19

doi:10.1016/j.apmr.2020.10.113

A Consensus Statement for the Management and Rehabilitation of Communication and Swallowing Function in the ICU: A Global Response to COVID-19

Communication Sciences and Disorders

Research output: Contribution to journal › Article › peer-review

18 Scopus citations

Abstract

Objective: To identify core practices for workforce management of communication and swallowing functions in coronavirus disease 2019 (COVID-19) positive patients within the intensive care unit (ICU). Design: A modified Delphi methodology was used, with 3 electronic voting rounds. AGREE II and an adapted COVID-19 survey framework from physiotherapy were used to develop survey statements. Sixty-six statements pertaining to workforce planning and management of communication and swallowing function in the ICU were included. Setting: Electronic modified Delphi process. Participants: Speech-language pathologists (SLPs) (N=35) from 6 continents representing 12 countries. Interventions: Not applicable. Main Outcome Measures: The main outcome was consensus agreement, defined a priori as ≥70% of participants with a mean Likert score ≥7.0 (11-point scale: 0=strongly disagree, 10=strongly agree). Prioritization rank order of statements in a fourth round was also conducted. Results: SLPs with a median of 15 years of ICU experience, working primarily in clinical (54%), academic (29%), or managerial positions (17%), completed all voting rounds. After the third round, 64 statements (97%) met criteria. Rank ordering identified issues of high importance. Conclusions: A set of global consensus statements to facilitate planning and delivery of rehabilitative care for patients admitted to the ICU during the COVID-19 pandemic were agreed by an international expert SLP group. Statements focused on considerations for workforce preparation, resourcing and training, and the management of communication and swallowing functions. These statements support and provide direction for all members of the rehabilitation team to use for patients admitted to the ICU during a global pandemic.

Original language	English
Pages (from-to)	835-842
Number of pages	8
Journal	Archives of Physical Medicine and Rehabilitation
Volume	102
Issue number	5
DOIs	https://doi.org/10.1016/j.apmr.2020.10.113
State	Published - May 2021

Bibliographical note

Publisher Copyright:
© 2021

Funding

Disclosure: Martin B. Brodsky discloses a relationship with MedBridge Inc. Amy Freeman-Sanderson was supported by a University of Technology Re-establishment Grant. The other authors have nothing to disclose. This consensus statement was endorsed by the European Society for Swallowing Disorders (ESSD) on 11/25/2020; Global Tracheostomy Collaborative (GTC) on 11/202020; Intensive Care Society (ICS) on 11/12/2020; Irish Association of Speech and Language Therapists (IASLT) on 11/172020; Japanese Association of Speech-Language-Hearing Therapists (JAS) on 11/08/2020; Japanese Society of Dysphagia Rehabilitation (JSDR) on 11/12/2020; Laryngological Society of Australasia (LSA) on 11/19/2020; Nederlandse Vereniging voor Lodopedie en Foniatrie (NVLF) on 11/06/2020; New Zealand Speech-language Therapists' Association (NZSTA) on 01/22/2021; Royal College of Speech Language Therapists (RCSLT) on 11/26/2020; Sociedade Brasileire de Fonoaudiologica (SBFa) on 11/09/2020; Society of Critical Care Medicine (SCCM) on 12/07/2020; Speech Pathology Australia (SPA) on 11/10/2020; Speech-Language & Audiology Canada (SAC) on 11/26/2020; The Swedish Association of Speech and Language Therapists (SLOF) on 12/10/2020. Disclosure: Martin B. Brodsky discloses a relationship with MedBridge Inc. Amy Freeman-Sanderson was supported by a University of Technology Re-establishment Grant. The other authors have nothing to disclose. This consensus statement was endorsed by the European Society for Swallowing Disorders (ESSD) on 11/25/2020; Global Tracheostomy Collaborative (GTC) on 11/202020; Intensive Care Society (ICS) on 11/12/2020; Irish Association of Speech and Language Therapists (IASLT) on 11/172020; Japanese Association of Speech-Language-Hearing Therapists (JAS) on 11/08/2020; Japanese Society of Dysphagia Rehabilitation (JSDR) on 11/12/2020; Laryngological Society of Australasia (LSA) on 11/19/2020; Nederlandse Vereniging voor Lodopedie en Foniatrie (NVLF) on 11/06/2020; New Zealand Speech-language Therapists' Association (NZSTA) on 01/22/2021; Royal College of Speech Language Therapists (RCSLT) on 11/26/2020; Sociedade Brasileire de Fonoaudiologica (SBFa) on 11/09/2020; Society of Critical Care Medicine (SCCM) on 12/07/2020; Speech Pathology Australia (SPA) on 11/10/2020; Speech-Language & Audiology Canada (SAC) on 11/26/2020; The Swedish Association of Speech and Language Therapists (SLOF) on 12/10/2020.

Funders	Funder number
European Society for Swallowing Disorders
Irish Association of Speech and Language Therapists
Japanese Association of Speech-Language-Hearing Therapists
Japanese Society of Dysphagia Rehabilitation
Laryngological Society of Australasia
MedBridge Inc
Nederlandse Vereniging voor Lodopedie en Foniatrie
Royal College of Speech Language Therapists
SLOF
Sociedade Brasileire de Fonoaudiologica
Swedish Association of Speech and Language Therapists
Society of Critical Care Medicine
Speech-Language and Audiology Canada
Australian and New Zealand Intensive Care Society
Technische Universiteit Delft
Jiangxi Academy of Sciences

Keywords

COVID-19
Communication
Critical care
Deglutition disorders
Rehabilitation
SARS-CoV-2
Telemedicine

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation

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10.1016/j.apmr.2020.10.113

Cite this

@article{bcafa3dfec394d09984e43446875c91c,

title = "A Consensus Statement for the Management and Rehabilitation of Communication and Swallowing Function in the ICU: A Global Response to COVID-19",

abstract = "Objective: To identify core practices for workforce management of communication and swallowing functions in coronavirus disease 2019 (COVID-19) positive patients within the intensive care unit (ICU). Design: A modified Delphi methodology was used, with 3 electronic voting rounds. AGREE II and an adapted COVID-19 survey framework from physiotherapy were used to develop survey statements. Sixty-six statements pertaining to workforce planning and management of communication and swallowing function in the ICU were included. Setting: Electronic modified Delphi process. Participants: Speech-language pathologists (SLPs) (N=35) from 6 continents representing 12 countries. Interventions: Not applicable. Main Outcome Measures: The main outcome was consensus agreement, defined a priori as ≥70% of participants with a mean Likert score ≥7.0 (11-point scale: 0=strongly disagree, 10=strongly agree). Prioritization rank order of statements in a fourth round was also conducted. Results: SLPs with a median of 15 years of ICU experience, working primarily in clinical (54%), academic (29%), or managerial positions (17%), completed all voting rounds. After the third round, 64 statements (97%) met criteria. Rank ordering identified issues of high importance. Conclusions: A set of global consensus statements to facilitate planning and delivery of rehabilitative care for patients admitted to the ICU during the COVID-19 pandemic were agreed by an international expert SLP group. Statements focused on considerations for workforce preparation, resourcing and training, and the management of communication and swallowing functions. These statements support and provide direction for all members of the rehabilitation team to use for patients admitted to the ICU during a global pandemic.",

keywords = "COVID-19, Communication, Critical care, Deglutition disorders, Rehabilitation, SARS-CoV-2, Telemedicine",

author = "Amy Freeman-Sanderson and Ward, {Elizabeth C.} and Anna Miles and {de Pedro Netto}, Irene and Sallyanne Duncan and Yoko Inamoto and Jackie McRae and Natasha Pillay and Skoretz, {Stacey A.} and Margaret Walshe and Brodsky, {Martin B.} and Archer, {Sally K.} and Sonia Baker and Liza Bergstr{\"o}m and Burns, {Clare L.} and Tanis Cameron and Michelle Cimoli and Clayton, {Nicola A.} and Gemma Clunie and Therese Cole and Camilla Dawson and Karen Dikeman and Brooke Duggan and Leanie Engelbrecht and Nicole Langton-Frost and Bronwyn Hemsley and Hanneke Kalf and Marta Kazandjian and Sunaina Lakha and Stevie Marvin and Melanie McIntyre and Jo Puntil-Sheltman and {do Nascimento Junior}, {Jos{\'e} Ribamar} and Suiter, {Debra M.} and Sutt, {Anna Liisa} and Sarah Wallace and Zaga, {Charissa J.}",

note = "Publisher Copyright: {\textcopyright} 2021",

year = "2021",

month = may,

doi = "10.1016/j.apmr.2020.10.113",

language = "English",

volume = "102",

pages = "835--842",

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AU - Freeman-Sanderson, Amy

AU - Ward, Elizabeth C.

AU - Miles, Anna

AU - de Pedro Netto, Irene

AU - Duncan, Sallyanne

AU - Inamoto, Yoko

AU - McRae, Jackie

AU - Pillay, Natasha

AU - Skoretz, Stacey A.

AU - Walshe, Margaret

AU - Brodsky, Martin B.

AU - Archer, Sally K.

AU - Baker, Sonia

AU - Bergström, Liza

AU - Burns, Clare L.

AU - Cameron, Tanis

AU - Cimoli, Michelle

AU - Clayton, Nicola A.

AU - Clunie, Gemma

AU - Cole, Therese

AU - Dawson, Camilla

AU - Dikeman, Karen

AU - Duggan, Brooke

AU - Engelbrecht, Leanie

AU - Langton-Frost, Nicole

AU - Hemsley, Bronwyn

AU - Kalf, Hanneke

AU - Kazandjian, Marta

AU - Lakha, Sunaina

AU - Marvin, Stevie

AU - McIntyre, Melanie

AU - Puntil-Sheltman, Jo

AU - do Nascimento Junior, José Ribamar

AU - Suiter, Debra M.

AU - Sutt, Anna Liisa

AU - Wallace, Sarah

AU - Zaga, Charissa J.

PY - 2021/5

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N2 - Objective: To identify core practices for workforce management of communication and swallowing functions in coronavirus disease 2019 (COVID-19) positive patients within the intensive care unit (ICU). Design: A modified Delphi methodology was used, with 3 electronic voting rounds. AGREE II and an adapted COVID-19 survey framework from physiotherapy were used to develop survey statements. Sixty-six statements pertaining to workforce planning and management of communication and swallowing function in the ICU were included. Setting: Electronic modified Delphi process. Participants: Speech-language pathologists (SLPs) (N=35) from 6 continents representing 12 countries. Interventions: Not applicable. Main Outcome Measures: The main outcome was consensus agreement, defined a priori as ≥70% of participants with a mean Likert score ≥7.0 (11-point scale: 0=strongly disagree, 10=strongly agree). Prioritization rank order of statements in a fourth round was also conducted. Results: SLPs with a median of 15 years of ICU experience, working primarily in clinical (54%), academic (29%), or managerial positions (17%), completed all voting rounds. After the third round, 64 statements (97%) met criteria. Rank ordering identified issues of high importance. Conclusions: A set of global consensus statements to facilitate planning and delivery of rehabilitative care for patients admitted to the ICU during the COVID-19 pandemic were agreed by an international expert SLP group. Statements focused on considerations for workforce preparation, resourcing and training, and the management of communication and swallowing functions. These statements support and provide direction for all members of the rehabilitation team to use for patients admitted to the ICU during a global pandemic.

AB - Objective: To identify core practices for workforce management of communication and swallowing functions in coronavirus disease 2019 (COVID-19) positive patients within the intensive care unit (ICU). Design: A modified Delphi methodology was used, with 3 electronic voting rounds. AGREE II and an adapted COVID-19 survey framework from physiotherapy were used to develop survey statements. Sixty-six statements pertaining to workforce planning and management of communication and swallowing function in the ICU were included. Setting: Electronic modified Delphi process. Participants: Speech-language pathologists (SLPs) (N=35) from 6 continents representing 12 countries. Interventions: Not applicable. Main Outcome Measures: The main outcome was consensus agreement, defined a priori as ≥70% of participants with a mean Likert score ≥7.0 (11-point scale: 0=strongly disagree, 10=strongly agree). Prioritization rank order of statements in a fourth round was also conducted. Results: SLPs with a median of 15 years of ICU experience, working primarily in clinical (54%), academic (29%), or managerial positions (17%), completed all voting rounds. After the third round, 64 statements (97%) met criteria. Rank ordering identified issues of high importance. Conclusions: A set of global consensus statements to facilitate planning and delivery of rehabilitative care for patients admitted to the ICU during the COVID-19 pandemic were agreed by an international expert SLP group. Statements focused on considerations for workforce preparation, resourcing and training, and the management of communication and swallowing functions. These statements support and provide direction for all members of the rehabilitation team to use for patients admitted to the ICU during a global pandemic.

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KW - Deglutition disorders

KW - Rehabilitation

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A Consensus Statement for the Management and Rehabilitation of Communication and Swallowing Function in the ICU: A Global Response to COVID-19

Abstract

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Keywords

ASJC Scopus subject areas

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