JCPSLP Vol 22 No 1 2020

ProQuest 428 citations

JCPSLP 14 citations

IJSLP 25 citations

SpeechBite 6 citations

Grey literature 2 citations

Cochrane 26 citations

Ebscohost 89 citations

CSU Primo 0 citations

Key author 1 citation

Web of science 269 citations

Sources extracted 860

Duplicates removed 205

Titles screened for topic relevance 655

Shortlist for abstract review 57

Shortlist for full review 42

Included sources 26

SLP focused 15

Setting focused 11

Key: JCPSLP: Journal of Clinical Practice in Speech-language Pathology IJSLP: International Journal of Speech-language Pathology

Figure 1. Search strategy flowchart

with Green and colleagues’ (2006) guidelines. Using this process, results were tabulated and critically appraised with instances of agreement and disagreement in the literature identified. Major themes and subthemes were established through an iterative process to identify key factors impacting service delivery at clinician, institution and policy levels in Australia with reference where relevant, to international contexts. Key themes emerging from the Major themes arising from the research included current SLP services and barriers to full service engagement. Subthemes related to service barriers included: poor understanding of SLP scope of practice in RACFs; limited SLP roles in practice; potential impact of “ageism”; communication access and quality issues; and a lack of recognition of RACFs as a clinical specialty site for speech-language pathologists. Theme 1: The current SLP role in RACFs RACFs are challenging clinical settings involving complex multi-morbidities and ethical challenges around palliation and evidence-based care (Bennett et al., 2015; Bennett et literature are discussed below. Literature review

al., 2016; Jeng, 2015). Little data describes SLP delivery models or services provided in RACFs (Bennett et al., 2015; Bennett et al., 2015a, Bennett et al., 2015b; Bennett et al., 2016). Bennett and colleagues (Bennett, Cartwright, & Young, 2019; Bennett, Young, & Cartwright, 2019) make a valuable contribution in this regard, surveying 145 speech- language pathologists working with older adults. Their study suggested that RACF speech-language pathologists are mostly contracted from private practice, often servicing several sites. Speech-language pathologists reported that swallowing assessments were most often performed, with management via texture modification (Bennett, Young, & Cartwright, 2019). The authors identified that broader environmental interventions at mealtimes to support swallowing and social communications were rarely provided and direct communication therapy was limited (Bennett, Young, & Cartwright, 2019). This does not align with data suggesting high needs for communication and mealtime management in RACFs (Bennett et al., 2015; Bennett et al., 2015a; Bennett et al., 2016; Walker & Paliadelis, 2016). Speech-language pathologists in the Bennett, Cartwright, and Young (2019) study attributed this to a lack of resources, especially time and referral scope.

55

JCPSLP Volume 22, Number 1 2020

www.speechpathologyaustralia.org.au