Exploring Consistency and Variation in Fibreoptic Endoscopic Evaluation of Swallowing Practice in Australia.

BACKGROUND: Fibreoptic endoscopic evaluation of swallowing (FEES) is an imaging technique used by speech-language pathologists (SLPs) and some other health professionals to assess swallowing. OBJECTIVES: The primary aim was to gain an insight into FEES practices in Australia by characterising SLPs who use FEES and identifying areas of consistency and variation in practice. The secondary aim was to explore factors associated with variation in practice. METHOD: Cross-sectional survey methodology was used. The link to a web-based survey was e-mailed to 351 SLPs who practised in adult dysphagia. RESULTS: The participation rate for the study was 18.8% (n = 66). Twenty-two SLPs (38.6%) used FEES. These SLPs represented a cross-section of workplace settings, caseloads, clinical and training experiences. Consistency and variation in FEES procedural and assessment practices were identified. Some procedural aspects of FEES varied according to whether a medical practitioner was present, type of FEES training, and number of FEES conducted per month. CONCLUSION: This research represents a benchmark in the knowledge of how FEES is used in Australia. Despite the small number of participants, the findings provide a foundation from which future research questions can be generated. More extensive examination of the use of FEES by SLPs is warranted. Further research is also required to establish methods for attaining and maintaining competency and to achieve consensus on which aspects of swallowing are assessed when using FEES and how the examination should be conducted.

Nil per os in the management of oropharyngeal dysphagia-exploring the unintended consequences.

Nil per os (NPO), also referred to as Nil by Mouth (NBM), is a health-related intervention of withholding food and fluids. When implemented in the context of a person with dysphagia, NPO aims to mitigate risks of aspiration. However, evidence demonstrating that NPO is beneficial as an intervention for people with dysphagia is lacking. This paper explores the theoretical and empirical evidence relating to the potential benefits and adverse effects of NPO and asserts that NPO is not a benign intervention. This paper argues for applying an ethics framework when making decisions relating to the use of NPO as an intervention for dysphagia, in particular addressing informed consent and a person's right to self-determination.

Optimising Patient Outcomes in Tongue Cancer: A Multidisciplinary Approach.

A multidisciplinary approach to the management of tongue cancer is vital for achieving optimal patient outcomes. Nursing and allied health professionals play essential roles within the team. We developed symposia comprising a series of online lectures offering a detailed perspective on the role each discipline and consumer perspective has in the management of patients with tongue cancer. The topics, including epidemiology and prevention, diagnosis, treatment planning, surgery, adjuvant care, and the management of recurrent or metastatic disease, were thoroughly examined. The symposia highlighted the significance of fostering collaboration and continuous learning through a multidisciplinary approach. This initiative should be relevant to healthcare professionals, researchers, and policymakers striving to enhance patient outcomes in tongue cancer care through innovative collaboration.