TECHNICAL SKILLS COMPETENCY

Transcription

1 TECHNICAL SKILLS COMPETENCY Date Education Plan Knowledge Competencies 1. Demonstrates Understanding of rationale for performing FEES a) Identifies indications & contraindications for the procedure, MBS vs. FEES b) Identifies objectives & goals of the exam c) Identifies the role of SLP; scope of practice & licensure laws. Teaching Method Response Evaluation Review Code Date/ Response Code Time Comments/ Handouts P.219 ASHA Healthcare Conference Clinical Indicators Grid Website: search FEES 2. Knowledge of patient populations/diagnoses for FEES Articles a) Head & Neck CA b) Trauma c) Neurodegenerative d) Neurosurgical e) Chronic Respiratory Disease f) Post thoracic/cardiac surgery g) Medically compromised 1

2 3. Knowledge of use of FEES in different areas of the continuum a) Acute care b) Inpatient Rehab c) Outpatient 4. Recognize the anatomical landmarks as viewed endoscopically a) Nasal b) Velum/Nasopharynx c) Oropharynx/ Tongue bas d) Hypopharynx e) Larynx f) Trachea 5. Recognize physiology of the aero-digestive system endoscopically Handout- Nasal Cavity (Kim) Chapter 2 Langmore book a) Tongue base movements b) Epiglottic inversion c) Velopharyngeal competence d) Pharyngeal wall movement e) Laryngeal movement Adduction on volitional cough Phonatory adduction Arytenoid adduction Airway closure f) Sensory Function 2

3 6. Recognize neurologic vs. mechanical disruptions endoscopically Website a) Movement dysfunctions b) Unilateral vs. Bilateral deficits c) Post-surgical disruptions d) Congenital birth defects e) Distinction from normal aging f) Tracheostomy and ventilator issues 7. Knowledge of normal swallow viewed endoscopically 8. Knowledge of Exam Protocols a) Positioning scope for optimum view b) Evaluating structures and movement c) Sensory testing d) Administration of food/liquid to assess swallow functioning including use of compensatory strategies and maneuvers Website Website 9. Recognizes behavioral disorders endoscopically a) Psychogenic dysphagia with no overt etiology Psychogenic dysphagia in cases of additional 3

4 (primary or secondary) etiology 10. Knowledge of additional supplies a) 4x4 gauze pads b) Alcohol pads c) Lubricant d) Topical anesthetic (optional) e) Green/blue food dye (optional) f) Food/liquid g) Spoon/ cups/straws h) Endosheaths (optional) Website 12. Knowledge of adverse/ allergic reactions to topical anesthetics and decongestants ASHA policy statement Safety Article a) Tachycardia associated with epinephrine b) Vaso-vagal response c) Nasal inflammation d) Nasal turbinate hypertrophy e) Implications of blood thinners and hemophilia f) Dosage and side effects of any medication used in the procedure 4

5 13. Demonstrate technical components of equipment a) Defogging b) Endoscope handling/ orientation c) Scope insertion, placement, and maneuvering techniques 14. Demonstrate universal precautions before, during, and after FEES procedure Lecture Langmore book chapter 4 (Joseph Murray) Epidemology a) Use of gloves b) Endoscope high-level disinfection Cleaning/sterilizing agents Biohazard Endosheaths 15. Demonstrate exam protocol a) Positioning scope for optimum view b) Evaluating structures and movement c) (Sensory testing) Administration of food/liquid to assess swallow functioning including use of compensatory strategies and maneuvers 16. Demonstrate interpretation of findings Hands on Training Lecture a) Anatomical /structural deviations b) Sensory deficits c) Swallow function 5

6 d) Assessment of swallow safety e) Recommendations 17. Knowledge of endoscopy as biofeedback tool for treatment Scope Passes Date/Supervisor Initials Normal Abnormal Comments 6

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