Perspectives on Barriers and Facilitators with Implementation of Speaking Valves to Adult Tracheostomy Patients

Date of Submission

Spring 2025

Document Type

Closed Research Project

Degree Name

Master of Science in Speech-Language Pathology

Department

Speech-Language Pathology

First Advisor

Maria Centeno-Vazquez, PhD, CCC-SLP, BCS-S

Abstract

Purpose: This study examined speech-language pathologists’ (SLPs’) perspectives on barriers and facilitators associated with implementing speaking valves in adult tracheostomy patients. The study also explored factors influencing interprofessional collaboration, referral processes, education, and clinical implementation practices. Method: A descriptive survey research design was utilized through a 32-item anonymous online questionnaire distributed between June 2024 and January 2025. Participants included 80 speech-language pathologists with experience working with adult tracheostomy patients. Recruitment occurred through professional speech-language pathology networks, social media groups, and snowball sampling methods. Quantitative data were analyzed using descriptive statistics, and qualitative responses were coded into common themes. Results: Participants identified limited interprofessional collaboration, inconsistent referral processes, patient medical complexity, poor staff carryover, and limited education among healthcare professionals as primary barriers to speaking valve implementation. Strong interdisciplinary collaboration, effective communication, structured referral systems, ongoing education, and patient motivation were identified as key facilitators. Most participants reported high confidence in implementing speaking valves and recognized substantial physiological and communication benefits associated with their use. Although 99% of participants reported working in facilities supporting speaking valve use, only 31% reported the presence of a tracheostomy team. Additionally, 70% indicated their graduate training did not adequately prepare them to work with adult tracheostomy patients. Conclusions: Findings emphasize the importance of standardized protocols, interprofessional collaboration, and continuing education in facilitating timely and effective speaking valve implementation. Results further support the expanding clinical role of speech-language pathologists in tracheostomy management and highlight the need for increased advocacy, interdisciplinary training, and structured clinical pathways to improve communication access and patient-centered care for adult tracheostomy patients.

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