Why We Properly Train Our SLPs To Monitor Vital Signs

By Jonross Neptune, MS, CCC-SLP

Director of SLP Clinical Services

In a variety of different treatment settings, we are witnessing speech-language pathologists being asked to take and record vital signs despite the fact that SLPs are generally not trained to monitor vital signs within their program coursework.

Personally, I was caught off guard early in my career the when I was asked by a physical therapist to take the blood pressure of a patient I was treating. They viewed me as a medical professional that was able to evaluate and treat a patients’ communication and swallowing abilities, but I had to explain that I had never been trained to properly monitor their vital signs.

For me, this was extremely upsetting. Here I am: A therapist working in a medical facility that had yet to be trained appropriately on monitoring vital signs.

I found this unacceptable.

If being asked to monitor a vital sign was something that could happen in the future, I wanted to make sure I never had to tell someone I didn’t have the necessary skills again. I immediately sought out training and became well-versed in monitoring vital signs.

INTEGRATING VITAL SIGN TRAINING INTO THE FOX PRACTICE

Fast forward 10 years.

I work for a practice that feels strongly that all members of the FOX Rehabilitation team should be well trained in the monitoring of patients’ vital signs. This strong feeling comes from the fact that we can practice in an isolated treatment environment. We are often the only skilled medical professional in the home at any given time with the possibility that our patient might not see another individual until our next treatment session.

With these advantages and challenges comes a certain responsibility as a medical professional to be confident in patient monitoring and differential diagnosis.

We decided to train all of our current SLPs as well as any new SLP to join our practice in the future knowing it would be a large but necessary undertaking. We needed a training that was scalable and one that remained consistent with our focus on clinical excellence. We accomplished this by providing a training that consists of educational material, videos, and a hands-on skills demonstration.

Training rehab teams — SLPs, OTs, PTs — to monitor vital signs has been a highly controversial topic with many valid points being made in favor of this now-common practice, especially within the field of SLP. The American Speech-Hearing Association defines the monitoring of vital signs as a basic patient care skill that is easily trainable and should be considered (ASHA, 1997).

FOX regarded many different factors recommended by ASHA in our “Multiskilled Personnel” position statement, such as our patient population and delivery setting when determining our stance on this topic.

WHY FOX AS A PRACTICE UNDERTOOK VITAL SIGN MONITORING

To understand why we train our SLPs to monitor vital signs, one must understand our unique treatment model and patient population.

We are an outpatient private practice that provides geriatric house calls to the highly complex older adult population in the comfort of their own home under Medicare Part B. Our patients have an average age of more than 80 years and oftentimes present with more than one chronic condition, limited social support, and have been recently hospitalized.

This treatment approach presents us with many advantages, such as autonomy in setting our plans of care and working with patients in a more natural environment with activities that are meaningful.

Outpatient therapy in the home encourages us to practice at the top of our license.

We have to be well-versed in the management of chronic conditions, such as chronic obstructive pulmonary disease, congestive heart failure, and pneumonia. Being involved with our practice’s specific patient population, it is very likely that the need to monitor a patient’s vital signs and perform any necessary actions based on the findings will arise at some point. This alone was enough for us to make the call to train our SLPs to monitor patient vital signs.

THE IMPORTANCE OF PROVIDING EXCELLENT CARE

We also fundamentally believe that the delivery of health care can be enhanced with an integrated healthcare team. Take hospitalizations and re-hospitalizations for example. Chronic disease is the primary reason for initial and re-hospitalization in older adults.

Shouldn’t all members of the healthcare team be able to intervene should a medical emergency arise?

If we have properly trained clinicians who are able to make appropriate referrals when the symptoms are outside of our scope of practice, we have a healthcare system one step closer to reaching the common goal of keeping our patients medically and functionally well and out of the hospital.