{
  "abstract": "Why did you do this work? The One-Way Tracheostomy Valve (OWV) has evolved beyond its label as a ‘speaking valve.’ A scoping review by Zabih et al. (2017) emphasized that much existing literature focused on valve use/tolerance rather than broader multisystem benefits. The review suggests more research is needed to reduce morbidity and mortality in paediatric tracheostomy patients. Lian et al. (2022), though studying adults, also call for further research to standardise valve use. While guidelines exist, there is no comprehensive tool addressing all aspects of OWV consideration including individualised risk/benefit within a holistic context.What did you do? The Speech and Language Therapist (SLT) and Respiratory Physiotherapist (RP) developed a comprehensive decision-making tool ( figure 1) for use with the paediatric tracheostomy long-term ventilated population. This tool standardises the decision-making process for OWV use, considering all necessary factors for this complex cohort.The tool allows for an individualised, patient-specific analysis of risks and benefits, drawing information from multiple sources. It evaluates overall status and function while incorporating multisystem variables such as respiratory function, secretion management, upper airway, swallowing, and vocal abilities. It also accounts for the child’s long-term ventilation pathway, which Brookes (2019) summarises as being the goal of LTV; a term recognised by leaders in the field.Effective use of the tool requires joint assessment and case review by the SLT and RP, in addition to liaison with other health and medical professionals and the patient/family themselves.Abstract 7867 Figure 1One-way tracheostomy valve decision making toolWhat did you find? We piloted this tool with 10 patients. The tool was refined to finalise content and determine a format that was conducive to the decision-making process.The tool proved effective in identifying risks and challenges for OWV use, guiding discussions in multi-professional meetings to determine the timing of OWV introduction and ways to mitigate risks.Parents found the tool helpful in managing their expectations, showing next steps or obstacles for OWV use. It also enhanced their understanding of the benefits and complexities involved. Feedback from colleagues highlighted its value in illustrating the detailed analysis required for OWV decisions, while also supporting the education of junior SLTs and RPs, promoting skill development.The tool also proved useful for consistent data collection across patients of all ages and medical complexities, tracking progress, and identifying factors leading to OWV success or failure.At this stage, only OWV competent SLTs and PTs could complete the tool due to the expert knowledge required for risk analysis.What does it mean? The OWV decision-making tool provides a comprehensive approach to identifying suitability and implementing OWV use. It supports multiprofessional management, improving patient safety, quality of care, and timely intervention.Family feedback has been positive, with better engagement in the transparent decision-making process and improved outcomes for children.The tool also documents specific multisystem baselines and changes, vital for much needed OWV benefits research and potentially demonstrating cost-saving benefits, such as, if liberated from ventilation or reduced need for alternative feeding methods.References Brookes, I. (2019) ‘Long term ventilation in children’, Paediatrics and Child Health, 29(4).Lian, S., Teng, L., Mao, Z. and Jiang, H. (2022) ‘Clinical utility and future direction of the speaking valve: A review’, Frontiers in Surgery, 9, p. 913147.Zabih, W., Holler, T., Syed, F., Russell, L. and Allegro, J. (2017) ‘The use of speaking valves in children with tracheostomy tubes’, Respiratory Care, 62(12), December.Funding N/AEthical Considerations N/A",
  "authors": [
    {
      "affiliations": [
        "Birmingham Children’s Hospital"
      ],
      "name": "Joanna Matthews"
    },
    {
      "affiliations": [
        "Birmingham Children’s Hospital"
      ],
      "name": "Audrey Martin"
    }
  ],
  "title": "7867 To valve or not to valve – the decision making process in the paediatric tracheostomy ventilated population",
  "uid": "190b3838-e965-59cf-ba99-766ef14e8396"
}