{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T08:01:08Z","timestamp":1769846468767,"version":"3.49.0"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T00:00:00Z","timestamp":1628208000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>There is increased involvement of speech and language therapists (SLTs) in critical care and long\u2010term units supporting patients with ventilatory needs and complex dysphagia. SLTs have a range of specialist knowledge in the function of the pharynx and larynx to enable them to support therapeutic interventions and contribute to the management of those patients. In Israel, there are currently no designated courses or training programmes for SLTs to establish advanced clinical skills in tracheostomy and ventilator management. There are currently standards of care for SLT working in designated wards for ventilated patients, however not in acute wards, critical care, and internal medicine wards where ventilated patients can be hospitalized.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To identify the skills and expertise of the Israeli SLT workforce working with tracheostomy patients. Specifically, to identify their level of training, access to training, client population, work settings, and level of work confidence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study involved electronic distribution of a 55\u2010item online survey to SLTs in Israel. The questions included demographic information, training, confidence, and clinical support.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Responses were received from 47 SLTs. The majority (40.4%) spent between 1% and 9% of their clinical time with ventilated patients. Almost 80% work with seniors (\u226565 years) and almost 70% work with adults (18\u201365 years) half the time or more. In inpatient rehabilitation, 46.8% reported that they manage patients with tracheostomy half the time or more. In outpatient rehabilitation settings, 21.3% reported that they manage patients with tracheostomy half the time or more. Prior to managing complex airway patients independently, 55.3% received less than 5 h formal tracheostomy training whilst 68.1% received less than 5 h training on ventilated patients. Multidisciplinary teams (MDTs) existed for tracheostomy patients (85.1%) and ventilated patients (70.2%) and high levels of confidence were reported for managing patients with tracheostomies (mode of 4 in a scale of 0\u20135, where 5 means fully confident) and ventilated patients (mode of 3 in a scale of 0\u20135). A significant relationship was found between level of confidence and presence of an MDT.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Limited training access was found for SLTs working with this complex population. A competency framework needs to be established with access to training and supervision. MDT existence contributes to confidence. Most respondents worked in rehabilitation settings, and very few worked in acute care, critical care, and internal medicine wards. It seems reasonable that in order to change this, minimal standards of care should be established on these wards.<\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds<\/jats:title><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p><jats:list list-type=\"bullet\"><jats:list-item><jats:p>Speech and language therapists (SLTs) have an important role in critical care and long\u2010term units supporting patients with complex dysphagia and undergo formal training and supervision in UK and Australia.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this paper adds to existing knowledge<\/jats:title><jats:p><jats:list list-type=\"bullet\"><jats:list-item><jats:p>In Israel, most SLTs work with tracheostomy and ventilated adult patients in rehabilitation settings, whilst few work in acute, critical care, and internal medicine wards. There are limited opportunities for formal training and supervision, although MDT support enhances clinical confidence.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the potential or actual clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\"><jats:list-item><jats:p>SLTs in Israel would benefit from establishing a competency framework for tracheostomy and ventilator patient management to support training, standards of care, and increase clinical involvement in acute settings. This will enhance clinical outcomes for their large population of complex airway patients.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.12655","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T09:55:11Z","timestamp":1628243711000},"page":"1053-1063","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Speech and language therapists\u2019 management of ventilated patients and patients with tracheostomy in Israel"],"prefix":"10.1111","volume":"56","author":[{"given":"Oshrat","family":"Sella Weiss","sequence":"first","affiliation":[{"name":"Department of Communication Sciences and Disorders University of Haifa Haifa Israel"},{"name":"Speech and Language Department, Reuth Rehabilitation Hospital Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aviah","family":"Gvion","sequence":"additional","affiliation":[{"name":"Speech and Language Department, Reuth Rehabilitation Hospital Tel Aviv Israel"},{"name":"Department of Communication Sciences and Disorders Ono Academic College Kiryat Ono Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jackie","family":"Mcrae","sequence":"additional","affiliation":[{"name":"Center for Allied Health St George's University of London United Kingdom of Great Britain and Northern Ireland, London UK"},{"name":"Speech and Language Therapy Department University College London Hospitals, NHS Foundation Trust"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,8,6]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"American Speech\u2010Language\u2010Hearing Association.Tracheostomy and Ventilator Dependence (Practice Portal)[Online]. Available from:The reference Tracheostomy and Ventilator Dependence (Practice Portal) [Online]. Available is listed in the references list but is not cited in the text. Please either cite the reference or remove it from the references list.https:\/\/www.asha.org\/Practice\u2010Portal\/Professional\u2010Issues\/Tracheostomy\u2010and\u2010Ventilator\u2010Dependence\/[Accessed 1st January 2020]."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3376-3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S118419"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000003368"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/S1441-2772(23)01826-4","article-title":"Outcomes of patients with spinal cord injury before and after introduction of an interdisciplinary tracheostomy team","volume":"11","author":"Cameron T.S.","year":"2009","journal-title":"Critical Care and Resuscitation"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aucc.2020.02.003"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-4486.2011.02379.x"},{"key":"e_1_2_8_9_1","volume-title":"Communication and swallowing management of tracheostomized and ventilator dependent adults","author":"Dikeman K.","year":"2002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20248"},{"key":"e_1_2_8_11_1","unstructured":"FACULTY OF INTENSIVE CARE MEDICINE & INTENSIVE CARE SOCIETY. 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(2020)Hospital beds and licensing stations 2019[Online]. Available from:https:\/\/www.health.gov.il\/PublicationsFiles\/beds2020.pdf[Accessed 1st January 2020]."},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2012.11.008"},{"key":"e_1_2_8_25_1","unstructured":"Royal College of Speech and Language Therapists. (2014)Tracheostomy Competency Framework[Online]. London. Available from:https:\/\/www.rcslt.org\/members\/publications\/publications2\/tracheostomy_competency_framework[Accessed 25th February 2015]."},{"key":"e_1_2_8_26_1","unstructured":"Royal College of Speech and Language Therapists. (2019)Best Practice Guidance for Speech and Language Therapists (SLTs) Working in Critical Care[Online]. Available from:https:\/\/www.rcslt.org\/members\/clinical\u2010guidance\/critical\u2010care\/critical\u2010care\u2010guidance#section\u20101[Accessed 1st October 2019]."},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(15)00007-7"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00455-020-10115-0"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000004098"},{"key":"e_1_2_8_30_1","unstructured":"Speech Pathology Australia. (2013)Tracheostomy management: Position paper[Online]. Melbourne. 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