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Speaking Up for the Speechless

When her patients couldn’t speak, Rebecca Koszalinski was listening.

“I want to speak for myself.”

Six quiet words, but to College of Nursing Assistant Professor Rebecca Koszalinski, their impact was loud and resonating.

Delivered by a patient dealing with the effects of a debilitating disease, the statement became a rallying cry and the inspiration behind Koszalinski’s Speak for Myself app, which helps intubated and voiceless patients communicate with medical staff.

As a certified rehabilitation nurse, Koszalinski understands the importance of being heard. And as a self-described “tech nerd,” she knew that spoken words weren’t necessarily required.

Too often, Koszalinski had witnessed patients’ frustration at being unable to communicate their needs, from the simplest bathroom request to complicated questions regarding their diagnosis and prognosis.

“Patients without a voice tend to feel ignored,” she says. Voiceless patients are not the only ones to suffer from a lack of communication. “Providers are just as desperate to understand, but their time is limited,” Koszalinski adds.

So began a journey to create an easy-to-use comprehensive communication method that would improve care for patients suffering from cerebral palsy, spina bifida, and other diseases that affect the ability to speak.

Speak for Myself is a culmination of years of clinical, surgical, and rehabilitation experience; input from countless patients, engineers, and programmers; and extensive independent study.

The resulting app utilizes large graphics designed specifically to accommodate people with limited dexterity. Features range from a body graphic for pinpointing pain locations to call buttons for family, friends, and medical staff.

The app contains a predictive engine, touch capacity, and an option for patients to write their own menu, personalizing the options for their particular needs.

With Speak for Myself, medical personnel no longer have to wait for laborious communication attempts via dry-erase board. Patient responses and requests are instantly communicated and easy to understand.

Koszalinski came to the College of Nursing in 2015 from Florida, where Speak for Myself was made available on Android tablets for early trials at three hospitals.

Today, with an internal grant from UT, Koszalinski has partnered with Sadie Hutson, associate professor of nursing, and Xueping Li, associate professor of industrial and systems engineering and director of the Ideation Laboratory in the Tickle College of Engineering, as well as graduate students in audiology and speech pathology, to create an updated version that will work across a wide variety of platforms. Further testing is forthcoming in hospitals throughout Knoxville and East Tennessee.

By giving voice to the voiceless, one nurse has improved patient outcomes and demonstrated how Volunteers make a difference.

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