Factors affecting speech pathologists’ implementation of stroke management guidelines: a thematic analysis

Miao, Melissa; Power, Emma; O’Halloran, Robyn

doi:10.3109/09638288.2014.932444

Cited by 47 publications

(76 citation statements)

References 49 publications

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“…Consistent with previous studies, participants in this study also expressed that any pathway designed should include the capacity to audit performance (Hadely et al, 2014;Miao et al, 2015), however given the desire to devolve accountability to clinicians it is perhaps prudent to ensure that ownership of the audit-feedback cycle lies with clinicians.…”

Section: How Can the Empowerment Of Speech Pathologists For Ebp In Acsupporting

confidence: 53%

“…In the first in-depth qualitative study exploring stroke guideline implementation by speech pathologists, Miao, Power and O'Halloran (2015) indicated that speech pathologists considered the perceived relevance of the guidelines to their workplace, the degree of change required compared to the available resources, and their personal motivation to make change in their clinical practice when attempting to integrate recommendations into practice.…”

Section: Recommendations For Best Practice In the Management Of Aphasmentioning

confidence: 99%

“…Participants in this study keenly supported the notion of a standardised, evidence-supported care pathway for acute aphasia management. Consistent with knowledge transfer and exchange models (Graham et al, 2006), each stage of the knowledge creation process -design, implementation, and evaluation -should be tailored to the needs of the potential users (Hadely, Power, & O'Halloran, 2014;Miao et al, 2015).…”

Section: How Can the Empowerment Of Speech Pathologists For Ebp In Acmentioning

confidence: 99%

“…Research Excellence in Aphasia Rehabilitation, 2014), the NHMRC Centre for Clinical Research Excellence in Aphasia Rehabilitation used a rigorous process to develop a series of 82 best practice statements which described optimal service provision for people with aphasia (Power et al, 2015).…”

Section: The Implications Of Current Aphasia Management Practice In Amentioning

confidence: 99%

“…However, discipline-specific nuances have also been acknowledged (Scott et al, 2012). Miao, Power and O'Halloran (2015) undertook interviews with eight Australian speech pathologists, including five working in the acute hospital setting, regarding the implementation of the clinical guidelines for stroke, including those relevant to aphasia. Themes highlighted that when implementing recommendations there is the need to consider: the perceived relevance of the guidelines to the context of the workplace; the change required compared to the available resources; and, the influence of personal motivation to make change in their clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

Foster¹

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While in the past the focus of speech pathologists working in the acute hospital setting has been service provision to people with communication disorders and their families, their primary role is now in dysphagia. In the limited literature regarding aphasia management in acute hospital settings, there is a lack of consistency regarding the type and amount of intervention being provided to people with aphasia; however, there is consensus that current practice is inconsistent with bestpractice recommendations. Given that aphasia intervention has been identified as being central to improved communicative outcomes, an increased capacity to effectively communicate healthcare needs, a decrease in hospital negative events, and an increased sense of satisfaction for people with aphasia, this is of concern. Little is known about the reasons underlying this evidence-practice gap.The overall aim of this thesis was to provide an understanding of current acute aphasia management practice and the factors that influence it. Specifically, the research aimed to: (a) provide an in-depth understanding of the current aphasia management pathway in the acute hospital setting; (b) explore acute speech-language pathologists' conceptualisation, experiences, and perceptions of post-stroke aphasia management, and provide a greater understanding of the factors that influence their practice; and, (c) understand the factors that influence acute aphasia management from the perspectives of speech pathologists, people with aphasia, and their close others, through a cultural lens.In order to address the research aims, the empirical aspects of this research were conducted in two Phases. Phase One, an interpretative phenomenological investigation, aimed to provide a deep understanding of aphasia management from the perspective of acute speech pathologists. Semistructured, in-depth interviews were undertaken with 15 Australian speech pathologists working with people with aphasia (one of which was later excluded resulting in a total n=14). Interviews were transcribed verbatim, and data were analysed using a thematic analysis. Key themes identified included: role perception; competing priorities; the de-prioritisation of aphasia; and, the sense of disempowerment experienced by speech pathologists as a result of their relationship with evidencebased practice for acute aphasia management. In addition, a qualitative content analysis was undertaken to describe the current aphasia management pathway. Grounded within the guiding construct, First contact with the profession, the findings represented the significant diversity in the ii pathways of care for people with aphasia and their families in the acute hospital setting. Overall, analysis revealed the complex, diverse, and multi-faceted nature of the phenomenon.Phase Two was designed based on the findings of Phase One. It examined the culture of acute aphasia management by speech pathologists in depth, through the use of focused ethnography in a single acute stroke unit. Three participant triads...

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Section: How Can the Empowerment Of Speech Pathologists For Ebp In Acsupporting

confidence: 53%

Section: Recommendations For Best Practice In the Management Of Aphasmentioning

confidence: 99%

Section: How Can the Empowerment Of Speech Pathologists For Ebp In Acmentioning

confidence: 99%

Section: The Implications Of Current Aphasia Management Practice In Amentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

Foster¹

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Barriers and facilitators to the implementation of clinical practice guidelines in sonography

2019

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Knowledge of the size of the adult liver is an essential factor in diagnosing liver disease and in the monitoring of treatment response over time. Although there are multiple methods to determine liver size using ultrasound, currently, no clinical practice guideline exists. Recently, a reference range and equation to determine liver volume using ultrasound was developed. In order to guide the development of a clinical guideline, a scoping review was conducted in order to identify the potential barriers and facilitators to the implementation of this new measurement technique in clinical practice. A total of 40 articles were included in the review. The most commonly cited barriers to guideline adherence can be divided into categories that are related to individual barriers (knowledge and attitude) and external factors (guideline and environmental). The facilitators to overcome such barriers were also identified. It was reported that implementation is most beneficial when a range of strategies that aim to address the identified barriers are used. In conclusion, this scoping review has identified barriers and facilitators to aid in the development of interventions to improve sonographers' adherence to clinical practice guidelines in the clinical environment.

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An Evaluation of Texture-Modified Diets Compliant with the International Dysphagia Diet Standardization Initiative in Aged-Care Facilities Using the Consolidated Framework for Implementation Research

Miles

Braakhuis

2022

Dysphagia

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Factors affecting speech pathologists’ implementation of stroke management guidelines: a thematic analysis

Cited by 47 publications

References 49 publications

“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

“Communication is taking a back seat”: An exploration of aphasia management in acute hospital settings

Barriers and facilitators to the implementation of clinical practice guidelines in sonography

An Evaluation of Texture-Modified Diets Compliant with the International Dysphagia Diet Standardization Initiative in Aged-Care Facilities Using the Consolidated Framework for Implementation Research

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