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[jpetrella]

COPY THEN PASTE IN REPLY AND FILL OUT-MARK "X" NEXT TO YOUR ANSWER CHOICE

Swallowing and Feeding Difficulties in a Patient With a Tracheostomy

Directions: To the best of your ability, fill out all four sections completely and honestly.

PART 1 - Background Information

1.) Age: Gender:

2.) College or University:

3.) Status: (a) freshman (b) sophomore © junior (d) senior (e) other

4.) What degree are you working towards?

(a) Associates (b) Bachelors © Masters (d) Doctorate (e) other

5.) What area would you like to work in?

6.) Do you have any work experience in the hospitals? (a) yes (b) no

If yes:

In what setting(s) (Emergency, Pediatric, Maternity, etc.)?

7.) Have you ever taken a class that was specific to teaching swallowing disorders and/or

tracheostomies? Yes No What was the class called?

PART 11 - Swallow Overview

Please Circle:

1.) What is the appropriate term for a disorder in swallowing?

(a) dysarthria (b) dysphasia © dysphagia (d) aphasia (e) dyspnea

Please Fill-in:

2.) What is the optimum position for feeding and swallowing?

(a) standing (b) laying down © sitting at 45 degree angle (d) sitting upright

3.) Would you be able to identify signs/symptoms of a swallowing impairment?

(a) yes (b) no

If so, please list three symptoms:

1) , (2.) , (3)

Please Circle:

5.) What discipline(s) has a role in swallowing impairments? (Circle all that apply):

(a) Occupational Therapist © Speech-Language Pathologist

(b) Certified Nurse Assistant (d) Other

6.) Would you follow instructions given to you by a speech pathologist on the care and

management of a patient with feeding and/or swallowing issues? (Circle)

(a) Yes (b)No © Unsure (d) I Don't know what a Speech

Pathologist is

PART 111 - Tracheostomy Overview

Please Fill-In:

1.) How does a tracheostomy tube affect a person's speech and swallow?

Please Circle:

2.) When eating and drinking, the cuff should be...

(a) Inflated (b) deflated © worn on the outside (d) people can only eat with fenestrated tubes

True / False

3.) The main purpose of a cuffed tracheostomy tube is to prevent aspiration. True False

4.) The use of a one-way speaking valve can hinder swallowing. True False

5.) Aspiration is when you exhale. True False

6.) Patients who have a swallowing disorder may not develop early onset pneumonia.

True False

Please Circle:

7.) Which is a protective mechanism for airway clearance?

(a) gag reflex © choking reflex

(b) cough reflex (d) swallowing reflex

(e) acid reflex

PART 1V - Your Opinion

1.) Do you think you would ever want to specialize in this area of care? (a) yes (b) no

If no please explain:

2.) Do you think university/college programs should focus more on feeding and/or swallowing issues?

(a) yes (b) no © unsure

Please Circle the statement that best describes your opinion:

3.) (a) I think higher education institutions who offer nursing programs should dedicate a course specific to tracheostomy care and swallowing management.

(b) If institutions offered a course specific to tracheostomy care and swallowing management, I do not think I would benefit much from it.

© Academic programs in nursing are offering sufficient courses to address these issues.

Please Circle the statement that best describes your feeling:

4.) (a) As of right now, I feel confident in caring for this population of patients.

(b) As of right now, I do not feel confident in caring for this population.

© As of right now, I am unsure if I am competent to care for this population.

COMMENTS:

J Thank you for taking your time to complete this survey J

[traumaRUs, MSN, APRN]

Sorry, but this isn't a survey, it looks like a homework assignment. I would suggest a good med-surg textbook and look up the answers. GOod luck.