A consensus statement for the management and rehabilitation of communication and swallowing function in the ICU: A global response to COVID-19
File(s)
Accepted version
Author(s)
Type
Journal Article
Abstract
Objective
To identify core practices for workforce management of communication and swallowing functions in COVID-19 positive patients within the ICU.
Design
A modified Delphi methodology was utilized, 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
35 speech-language pathologists (SLPs) 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 4th round was also conducted.
Results
SLPs with a median of 15 years ICU experience, working primarily in clinical (54%), in academic (29%) or managerial (17%) positions, 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 focus 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.
To identify core practices for workforce management of communication and swallowing functions in COVID-19 positive patients within the ICU.
Design
A modified Delphi methodology was utilized, 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
35 speech-language pathologists (SLPs) 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 4th round was also conducted.
Results
SLPs with a median of 15 years ICU experience, working primarily in clinical (54%), in academic (29%) or managerial (17%) positions, 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 focus 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.
Date Issued
2021-05
Date Acceptance
2020-10-26
Citation
Archives of Physical Medicine and Rehabilitation, 2021, 102 (5), pp.835-842
ISSN
0003-9993
Publisher
Elsevier
Start Page
835
End Page
842
Journal / Book Title
Archives of Physical Medicine and Rehabilitation
Volume
102
Issue
5
Copyright Statement
© Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence http://creativecommons.org/licenses/by-nc-nd/4.0/
Identifier
PII: S0003999320312107
Subjects
COVID-19
Communication
Critical care
Deglutition disorders
Rehabilitation
SARS-CoV-2
Telemedicine
COVID-19 SLP Global Group
1103 Clinical Sciences
1106 Human Movement and Sports Sciences
1117 Public Health and Health Services
Rehabilitation
Publication Status
Published
Date Publish Online
2020-11-07