Objectives (1) Estimate the proportion of mechanically ventilated (MV) intensive care unit (ICU) patients meeting basic communication criteria who could potentially be served by assistive communication tools and speech-language consultation. (2) Compare characteristics of patients who met communication criteria with those who did not. Design Observational cohort study in which computerized billing and medical records were screened over a 2-year period. Setting Six specialty ICUs across two hospitals in an academic health system. Participants Eligible patients were awake, alert, and responsive to verbal communication from clinicians for at least one 12-h nursing shift while receiving MV ≥ 2 consecutive days. Main results Of the 2671 MV patients screened, 1440 (53.9%) met basic communication criteria. The Neurological ICU had the lowest proportion of MV patients meeting communication criteria (40.82%); Trauma ICU had the highest proportion (69.97%). MV patients who did not meet basic communication criteria (n = 1231) were younger, had shorter lengths of stay and lower costs, and were more likely to die during the hospitalization. Conclusions We estimate that half of MV patients in the ICU could potentially be served by assistive communication tools and speech-language consultation.

Preparing nurses to care for a growing population of older adults is one of the most significant challenges for nursing education. The purpose of the current study was to describe baccalaureate nursing students’ knowledge of and attitudes toward older adults, and explore the impact of a gerontological nursing course on their knowledge and attitudes. Results showed that students who had prior experience with older adults had significantly more positive attitudes toward them. Although students who participated in a gerontological nursing course had significantly higher knowledge scores than the comparison group, no significant difierence was noted in overall attitude. In addition, students who were enrolled in the gerontological nursing course or had prior experience with older adults were more likely to report plans to work with this population after graduation. Students who participated in interviews with older adults found the experience meaningful and their attitudes regarding older adults were largely positive. [ Journal of Gerontological Nursing , 41 (7), 46–56.]

The increased focus on patient and family-centered care in adult intensive care units (ICUs) has generated multiple platforms for clinician-family communication beyond traditional interdisciplinary family meetings (family meetings)-including family-centered rounds, bedside or telephone updates, and electronic family portals. Some clinicians and administrators are now using these platforms instead of conducting family meetings. For example, some institutions are moving toward using family-centered rounds as the main platform for clinician-family communication, and some physicians rely on brief daily updates to the family at the bedside or by phone, in lieu of family meetings. We argue that although each of these platforms is useful in some circumstances, there remains an important role for family meetings. We outline five goals of clinician-family communication-establishing trust, providing emotional support, conveying clinical information, understanding the patient as a person, and facilitating careful decision making-and we examine the extent to which various communication platforms are likely to achieve the goals. We argue that because no single platform can achieve all communication goals, an integrated strategy is needed. We present a model that integrates multiple communication platforms to effectively and efficiently support families across the arc of an ICU stay. Our framework employs bedside/telephone conversations and family-centered rounds throughout the admission to address high informational needs, along with well-timed family meetings that attend to families' emotions as well as patients' values and goals. This flexible model uses various communication platforms to achieve consistent, efficient communication throughout the ICU stay.

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Background With the growing population of individuals affected by Alzheimer's disease (AD) and related disorders, there is a pressing demand for research on late life cognitive disorders. However, the high risk for decisional incapacity in this population necessitates the evaluation of capacity to consent to research participation, adding to the cost and complexity of the research process. The University of California, San Diego Brief Assessment of Capacity to Consent (UBACC) was initially validated in a sample of persons with schizophrenia and healthy controls. Objective To assess the psychometric properties of the UBACC when used in a sample of individuals contemplating participation in research on AD. Methods The UBACC was administered to a convenience sample (n=132) consisting of individuals with mild to moderate cognitive impairment (n=52), their study partners (n= 52) and healthy older adults control subjects (n=30), as part of a broader study to evaluate perceived burden of research participation. Reliability tests, correlational analyses, and exploratory factor analytic methods were used to examine the psychometric properties of the instrument. Results UBACC scores were significantly associated with both global cognition (rs = .564, p < .001) and verbal fluency (rs = .511, P <.001), indicating concurrent validity with related constructs. The resulting factor structure differed from that reported by the developers in their initial testing. Items clustered almost entirely on one factor, and items reflecting the construct of understanding accounted for 32.12% of the total variance, with no evidence for distinct reasoning or appreciation scales. Conclusion The UBACC shows promise when used to screen for decisional capacity among those considering participation in AD research.