Newswise — Tracheostomies are among the most common procedures performed in critically ill patients, and various methods are available to help patients with tracheostomies regain the ability to speak, according to an article in the December issue of Critical Care Nurse (CCN).
The article, “Restoring Speech to Tracheostomy Patients,” provides an overview of nursing assessments and interventions to help patients regain the ability to speak after a tracheostomy.
Critical care nurses work as part of an interdisciplinary team that includes respiratory therapists, speech pathologists, advanced practice nurses and physicians to coordinate care and develop a patient-specific communication plan, which is essential to the goal of voice restoration.
Lead author Linda L. Morris, PhD, APN, CCNS, FCCM, is a tracheostomy specialist/consultant and associate professor of clinical anesthesiology, Feinberg School of Medicine, Northwestern University, Chicago. The co-editor/author of the 2010 edition of “Tracheostomies: The Complete Guide,” she also serves on the board of directors for the Global Tracheostomy Collaborative.
“Losing the ability to speak after a tracheostomy adds to the stress, fear and frustration of being critically ill,” she said. “Restoring speech to a patient after a tracheostomy allows them to more fully and effectively express their needs and wishes, participate in their plan of care and converse with their loved ones and caregivers.”
Speaking after a tracheostomy depends on having an adequate supply of air reach the vocal cords with a minimum of resistance, and the tracheostomy tube itself is an important factor related to phonation, or the ability to make sound with one’s vocal cords. Changing the type of tube, as well as its diameter or length, can help avoid complications and lead to greater success in phonation.
The article summarizes different approaches to restore phonation in patients with a tracheostomy, including special considerations related to nursing interventions. The methods vary, depending on whether the patient is spontaneously breathing, being treated with intermittent mechanical ventilation or is fully ventilator dependent.
“An essential component of successfully helping a patient regain the ability to speak is to determine which option or options are most appropriate, and nurses need to be aware of all the options available,” Morris said.
As the American Association of Critical-Care Nurses’ bimonthly clinical practice journal for high acuity, progressive and critical care nurses, CCN is a trusted source for information related to the bedside care of critically and acutely ill patients.
Access the article abstract and full-text PDF by visiting the CCN website at http://ccn.aacnjournals.org/.
About Critical Care Nurse: Critical Care Nurse (CCN), a bimonthly clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. The journal also offers columns on traditional and emerging issues across the spectrum of critical care, keeping critical care nurses informed on topics that affect their practice in high acuity, progressive and critical care settings. CCN enjoys a circulation of more than 105,000 and can be accessed at http://ccn.aacnjournals.org/.
About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than 500,000 acute and critical care nurses and includes more than 225 chapters worldwide. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. www.aacn.org; www.facebook.com/aacnface; www.twitter.com/aacnme
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Credit: American Association of Critical-Care Nurses
Credit: Linda Morris