Dr. Amy Freeman-Sanderson is a senior lecturer in Speech Pathology at UTS. She is a certified practicing speech pathologist with 17 years of clinical experience in fast-paced tertiary hospitals, both nationally and internationally. Through collaboration and strong leadership, Amy managed Speech Pathology services at one of Australia’s largest hospitals. She has trained and performed clinician-led nasendoscopy and videofluoroscopy for the assessment of swallow function.
Amy led a program of clinical research in critical care, conducting the inaugural RCT of early intervention for the return of voice in mechanically ventilated tracheostomy patients. Her work has been highly recognised, including publication in high impact journals, invitational lectures and top awards from the Australian and New Zealand Intensive Care Society and as a recipient of the University of Sydney Dean’s Scholar Award. Amy was awarded the Segelov Fellowship in 2015 and was the recipient of the inaugural Allied Health Seeding Grant from Sydney Local Health District in 2016.
Amy is actively engaged with ongoing research collaborations and supervision of both honours and higher degree research students. Her key research interests include dysphagia management, critical care, sepsis, health translation and building research capacity in the Speech Pathology profession.
Cardinal, LA, Freeman-Sanderson, A & Togher, L 2020, 'The speech pathology workforce in intensive care units: Results from a national survey', Australian Critical Care, vol. 33, no. 3, pp. 250-258.View/Download from: Publisher's site
© 2020 Background: Admission to the intensive care unit (ICU) with mechanical ventilation can lead to patients experiencing impaired swallowing and communication function. This can negatively affect patient experiences and outcomes. There is increasing research supporting early intervention for swallowing and communication; however, there are no published ICU workforce data to determine patient access. Purpose: The purpose of this study was to describe national ICU access to speech pathology (SP) services and to describe the nature of this workforce. Methods: Prospective audit of Australian ICUs with a focussed workforce survey of SP service including workforce demographics, clinical practices, team environments, and training was conducted. Data are described as percentage (%, n) and as median (interquartile range). Qualitative data were analysed using thematic frameworks. Results: SP services were available at 99% (n = 165) of the sites; 62 sites provided workforce data (45% response rate). Seventy-one percent of respondents serviced the ICU ≤10 h per week, with 23% reporting dedicated funding. Almost a third (32%) reported not participating in ICU team activities, and more than half of the sites (56%) did not provide ICU-specific training with resulting varied clinical confidence ratings. Facilitator and barriers both highlighted team working relationships. Facilitator themes were building working relationships, understanding the SP role in the multidisciplinary team, physical presence in the unit, and access to resources. Barrier themes were the multidisciplinary team's understanding of SP roles and lack of presence of SP services in the ICU. Conclusions: SP services are not standard across Australian ICUs, with variations in confidence, funding, training, and team environments. Further research into the impact of these variations on patient outcomes is needed.
Charters, EK, Bogaardt, H, Freeman-Sanderson, AL & Ballard, KJ 2019, 'Systematic review and meta-analysis of the impact of dosimetry to dysphagia and aspiration related structures.', Head & neck, vol. 41, no. 6, pp. 1984-1998.View/Download from: Publisher's site
BACKGROUND:Technological advances in radiotherapy have allowed investigations into new methods to spare healthy tissue in those treated for head and neck cancer. This systematic review with meta-analysis demonstrates the effect that radiation has on swallowing. METHODS:Selection and analysis of studies examining the effect of radiation to swallowing structures. A fixed effects meta-analysis calculated the pooled proportions for select outcomes of dysphagia, common across many studies. RESULTS:The majority of the papers found a correlation between radiation dose to the swallowing structures and dysphagia, however a meta-analysis found the studies carried a significant degree of heterogeneity. The appraisal demonstrates the need for large-scale studies using a randomized design and instrumental dysphagia assessments. CONCLUSIONS:Radiation dose to dysphagia and aspiration structures is correlated with incidence of dysphagia and aspiration. The variables in this population contribute to the heterogeneity within and cross studies and future studies should consider controlling for this.
Freeman-Sanderson, A, Morris, K & Elkins, M 2019, 'Characteristics of patient communication and prevalence of communication difficulty in the intensive care unit: An observational study.', Australian Critical Care, vol. 32, no. 5, pp. 373-377.View/Download from: Publisher's site
PURPOSE:To summarise the patient communication status in an intensive care unit (ICU), including methods of communication used and the frequency, degree and nature of communication breakdown. MATERIALS AND METHODS:A multidisciplinary daily ward audit was conducted on ten consecutive weekdays in a 30-bed general ICU of a tertiary Australian hospital. Data included patient demographics, patients' mode of communication and the level of difficulty in communicating. Descriptive statistics and means (standard deviation)/medians (interquartile range) were used to summarise the data. RESULTS:Over the audit period, data were collected from 87 patients (median age 58 years, interquartile range 43 to 67; 60% males), equivalent to 232 occupied bed days. Patients from non-English-speaking backgrounds accounted for 14% of the cohort, with Mandarin the most common non-English language. Altered cognition occurred on 11% of bed days. Staff reported difficulty in communicating with patients on 35% of bed days, with an inability to communicate with patients in 49% of these cases. Alternate modes of communication were reported, with gesture the most common, but they were not used with all suitable patients. CONCLUSIONS:About one-third of the caseload in the ICU experienced difficulty in communicating. While alternate communication methods were reported, they were not used with all patients. A multidisciplinary approach to enhance communication ability may be beneficial.
Freeman-Sanderson, AL, Togher, L, Elkins, M & Kenny, B 2018, 'Quality of life improves for tracheostomy patients with return of voice: A mixed methods evaluation of the patient experience across the care continuum', Intensive and Critical Care Nursing, vol. 46, pp. 10-16.View/Download from: Publisher's site
© 2018 Elsevier Ltd Objectives: A tracheostomy tube can profoundly impact ability to communicate. The impact of this on patients' self-esteem and quality of life in the care continuum from the intensive care unit to after decannulation has not been reported. Therefore, the aim was to investigate the patient-reported experience regarding change in communication function, communication-related self-esteem and quality of life. Research design: A mixed methods approach was utilised. Quantitative data were obtained using validated measures of self-esteem related to communication-related quality of life and general health. Data were measured before return of voice, within 48 hours of voice return and six months after tracheostomy decannulation. Qualitative data were collected through structured interviews six months after tracheostomy. Results: Seventeen participants completed the study. Four themes emerged from the interviews: It's hard communicating without a voice; What is happening to me?; A storm of dark emotions and More than a response...it's participating and recovering. Significant positive change occurred in six items of self-esteem related to communication from baseline to return of voice. Overall, positive changes in quality of life scores were observed. Conclusions: Voice loss with tracheostomy significantly affected participants' abilities to effectively communicate their care and comfort needs. Restoration of voice occurred in conjunction with patient-reported improved mood, outlook and sense of recovery.
Freeman-Sanderson, A 2016, 'One-Way, Positive-Pressure Speaking Valve During Mechanical Ventilation Via Tracheostomy Tube: Risks or Benefits? Reply', CRITICAL CARE MEDICINE, vol. 44, no. 11, pp. E1147-E1147.View/Download from: Publisher's site
Freeman-Sanderson, AL, Togher, L, Elkins, MR & Phipps, PR 2016, 'Quality of life improves with return of voice in tracheostomy patients in intensive care: An observational study', JOURNAL OF CRITICAL CARE, vol. 33, pp. 186-191.View/Download from: Publisher's site
Freeman-Sanderson, AL, Togher, L, Elkins, MR & Phipps, PR 2016, 'Return of Voice for Ventilated Tracheostomy Patients in ICU: A Randomized Controlled Trial of Early-Targeted Intervention', CRITICAL CARE MEDICINE, vol. 44, no. 6, pp. 1075-1081.View/Download from: Publisher's site
Freeman-Sanderson, A, Togher, L, Phipps, P & Elkins, M 2011, 'A clinical audit of the management of patients with a tracheostomy in an Australian tertiary hospital intensive care unit: Focus on speech-language pathology', INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY, vol. 13, no. 6, pp. 518-525.View/Download from: Publisher's site