Care Practice

Through Care Practice, we translate groundbreaking advancements into practical, evidence-backed guidelines and recommendations – working in partnership with you to deliver meaningful, measurable progress for every patient.

Adult Cochlear Implant (CI) Care Protocol

To support best-practice care for your adult patients, we have developed a protocol based on the latest evidence and international consensus recommendations. The protocol provides guidance at five key stages of the patient journey: candidacy, pre-surgery, activation, optimisation and maintenance. For each stage, the protocol describes:

What to do - the session goals for each stage

How to do it - clinical tasks to be completed in the session

Download the protocol

Stages of the Care Protocol

Candidacy evaluation

During a candidacy evaluation the patient’s current hearing status is evaluated to determine if they would be better served with a cochlear implant than their current technology. An audiological candidacy evaluation should occur as close as possible to the time a valid referral is received.

The session goals at this stage are:
Complete case history and audiological evaluation Verify hearing aid fitting Evaluate aided speech recognition Determine treatment recommendation and counsel

Preparing for surgery

A pre-surgery consultation prepares the patient for their hearing journey and establishes expectations. The pre-surgery consultation may take place during the candidacy evaluation or any time before surgery.

The session goals at this stage are:
Establish expectations Choose sound processor and complete order form

Activation

Activation should occur within two weeks post-surgery.^1-4 The goal at activation should be an acceptably loud and audible MAP (not necessarily an optimised MAP).

The session goals at this stage are:
Confirm status of the implanted ear Ensure C levels are set to ‘Loud’ Ensure audibility of soft sounds Ensure an adequate dynamic range (minimum 40 CL) Set expectations of wear time for all waking hours (typically 12+ hours per day)

Optimisation

This is the post activation period during which patients are seen in clinic or via Remote Care to optimise their MAP and sound processor settings. Optimisation typically takes 90 days, but duration depends on individual patient needs.

The session goals at this stage are:
Confirm status of the implanted ear and equipment Discuss at-home experience and review datalogs Confirm audibility and evaluate progress Optimise MAP and check loudness Check the contralateral ear

Maintenance

This phase typically begins 90+ days post-activation when performance has plateaued and MAP levels are stable.^5,6 During the maintenance phase patients can be monitored through Remote Care or clinic visits.

The session goals at this stage are:
Confirm status of the implanted ear and equipment Evaluate progress Determine need for ongoing support and technology upgrades

Download the Adult CI Care Protocol