An initial framework for use of ultrasound by speech and language therapists in the UK: Scope of practice, education and governance

Abstract

Background: There is growing evidence to support the use of ultrasound as a tool for the assessment and treatment of speech, voice and swallowing disorders across the Speech and Language Therapy profession. Research has shown that development of training competencies, engagement with employers and the professional body are vital to progressing ultrasound into practice. Methods: We present a framework to support translation of ultrasound into Speech and Language Therapy. The framework comprises three elements: (1) scope of practice, (2) education and competency and (3) governance. These elements align to provide a foundation for sustainable and high-quality ultrasound application across the profession. Results: Scope of practice includes the tissues to be imaged, the clinical and sonographic differentials and subsequent clinical decision-making. Defining this provides transformational clarity to Speech and Language Therapists, other imaging professionals and those designing care pathways. Education and competency are explicitly aligned with the scope of practice and include requisite training content and mechanisms for supervision/support from an appropriately trained individual in this area. Governance elements include legal, professional and insurance considerations. Quality assurance recommendations include data protection, storage of images, testing of ultrasound devices as well as continuous professional development and access to a second opinion. Conclusion: The framework provides an adaptable model for supporting expansion of ultrasound across a range of Speech and Language Therapy specialities. By taking an integrated approach, this multifaceted solution provides the foundation for those with speech, voice and swallowing disorders to benefit from advances in imaging-informed healthcare.

Assessing Swallowing Dysfunction Aggravation in Chronic Obstructive Pulmonary Disease Patients Using Ultrasonic Measurements With Swallowing Movement Parameters

“…14 At present, ultrasonic examination has the advantage of enhanced safety, high convenience, and low costs; as well as these, it can objectively measure the tongue, lingual muscle, hyoid bone, thyroid cartilage, the lateral pharyngeal wall, and other factors related to swallowing movement and their changes in COPD patients. 15 Therefore, this study aimed to investigate the value of assessing swallowing movement parameters using ultrasonic measurements in COPD patients with aggravation of swallowing dysfunction and to provide evidence for clinical treatment and improved patient prognosis.…”

“…In the past, swallowing angiography was commonly used to assess the swallowing dysfunction of patients, but it required patients to undergo invasive examinations under radiation conditions and could not detect muscle changes in the swallowing site of patients; therefore, it had many limitations 14 . At present, ultrasonic examination has the advantage of enhanced safety, high convenience, and low costs; as well as these, it can objectively measure the tongue, lingual muscle, hyoid bone, thyroid cartilage, the lateral pharyngeal wall, and other factors related to swallowing movement and their changes in COPD patients 15 . Therefore, this study aimed to investigate the value of assessing swallowing movement parameters using ultrasonic measurements in COPD patients with aggravation of swallowing dysfunction and to provide evidence for clinical treatment and improved patient prognosis.…”

Ultrasound image guided injection of botulinum toxin for the management of spasticity: A Delphi study to develop recommendations for a scope of practice, competency, and governance framework

“…A framework approach has been previously used 16 , 18 , 19 , 20 to define and align the elements of scope of practice (Scope), education for competency and governance for clinicians performing point of care ultrasound (PoCUS) imaging – as a mechanism for consolidating and expanding access to PoCUS. The framework approach ( fig 1 ; explanation of terms in table 1 ) is premised upon the inter-relationship of each of the components, whereby explicit alignment of each of the components provides the foundation for consolidation and expansion of practice.…”

“…This paper therefore shares some generic content with other areas of practice for PoCUS and we aim to provide a consistent approach to implementation and practice development support. 16 , 18 , 19 , 20

Fig 1 PoCUS framework triangle; adapted for UI in spasticity management (20). A framework for PoCUS.

…”