An Algorithm for Selecting a Communication Technique with Intubated Patients

Williams, Michael L.

doi:10.1097/00003465-199207000-00009

Cited by 13 publications

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“…To construct the algorithm we used the patient characteristics and the results which are presented in this systematic review. As a starting point we used the algorithm published by Williams in 1992 [ 27 ]. Through discussion, in the aforementioned working group, a hierarchy of assessment tasks to facilitate assessment and selection of communication methods was determined.…”

Section: Resultsmentioning

confidence: 99%

“…To accomplish our secondary aim, the studies included in this systematic review were analyzed to detect patient characteristics associated with the use of a specific communication method. The algorithm was developed based on the associations found between characteristics and communication methods, and an algorithm published by Williams in 1992 [ 27 ]. During the construct, the algorithm was discussed in a local working group on communication with critically ill patients, consisting of intensivists, critical nurses, and a PhD student.…”

Section: Methodsmentioning

confidence: 99%

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Communicating with conscious and mechanically ventilated critically ill patients: a systematic review

et al. 2016

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BackgroundVentilator-dependent patients in the ICU often experience difficulties with one of the most basic human functions, namely communication, due to intubation. Although various assistive communication tools exist, these are infrequently used in ICU patients. We summarized the current evidence on communication methods with mechanically ventilated patients in the ICU. Secondly, we developed an algorithm for communication with these patients based on current evidence.MethodsWe performed a systematic review. PubMed, Embase, Cochrane, Cinahl, PsychInfo, and Web of Science databases were systematically searched to November 2015. Studies that reported a communication intervention with conscious nonverbal mechanically ventilated patients in the ICU aged 18 years or older were included. The methodological quality was assessed using the Quality Assessment Tool.ResultsThe search yielded 9883 publications, of which 31 articles, representing 29 different studies, fulfilled the inclusion criteria. The overall methodological quality varied from poor to moderate. We identified four communication intervention types: (1) communication boards were studied in three studies—they improved communication and increased patient satisfaction, but they can be time-consuming and limit the ability to produce novel utterances; (2) two types of specialized talking tracheostomy tubes were assessed in eight studies—audible voicing was achieved in the majority of patients (range 74–100 %), but more studies are needed to facilitate safe and effective use; (3) an electrolarynx improved communication in seven studies—its effectiveness was mainly demonstrated with tracheostomized patients; and (4) “high-tech” augmentative and alternative communication (AAC) devices in nine studies with diverse computerized AAC devices proved to be beneficial communication methods—two studies investigated multiple AAC interventions, and different control devices (e.g., touch-sensitive or eye/blink detection) can be used to ensure that physical limitations do not prevent use of the devices. We developed an algorithm for the assessment and selection of a communication intervention with nonverbal and conscious mechanically intubated patients in the ICU.ConclusionsAlthough evidence is limited, results suggest that most communication methods may be effective in improving patient–healthcare professional communication with mechanically ventilated patients. A combination of methods is advised. We developed an algorithm to standardize the approach for selection of communication techniques.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-016-1483-2) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Communicating with conscious and mechanically ventilated critically ill patients: a systematic review

et al. 2016

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“…[17][18][19][20] It would be of great benefit to investigate what basic needs the intubated patients are encountering in relation to communication difficulties in surgical ICUs. Thus, the specific aims of this study were to (1) investigate the basic needs and communication difficulties in intubated surgical ICU patients; (2) identify the relationship among patient characteristics, including history of intubation, difficulty communicating, use of physical restraints, days of intubation, level of education, and basic needs; and (3) identify the predictors for basic needs of intubated patients in surgical ICUs.…”

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Basic needs and their predictors for intubated patients in surgical intensive care units

2009

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“…The inability to communicate, no matter how temporary, has been identified as one of the most frustrating and stressful aspects of an intensive care unit (ICU) admission for patients who are temporarily unable to speak (Dowden, Honsinger, & Beukelman 1986;Fitch, 1987;Fried-Oken, Howard, & Stewart, 1991;Gries & Fernsler, 1988;Hafsteindóttir, 1996;Hudelson, 1977;Jablonski, 1995;Menzel, 1994;Stovsky, Rudy, & Dragonette, 1988;Villaire, 1995;Williams, 1992). This is no less the case when an ICU admission is planned because of a condition such as a disorder of the upper airway or ventilator dependency or because of the need for a surgical intervention such as maxillofacial/orofacial reconstruction, organ transplantation, or an oncology-related procedure.…”

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confidence: 99%

“…Pain, potential changes in motor and sensory status, depression, and the effects of medications further reduce patients' ability to process new information. The results may include confusion, lack of comprehension, misinterpretation, and increased fear and tension (Stovsky et al, 1988;Williams, 1992). Anger, anxiety, fear, insecurity, and interference with sleep may also interfere with new learning in ICU settings (Menzel, 1994).…”

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confidence: 99%

AAC intervention in the intensive care unit: The children's hospital Boston model

Costello¹

2000

Augmentative and Alternative Communication

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An Algorithm for Selecting a Communication Technique with Intubated Patients

Cited by 13 publications

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Communicating with conscious and mechanically ventilated critically ill patients: a systematic review

Communicating with conscious and mechanically ventilated critically ill patients: a systematic review

Basic needs and their predictors for intubated patients in surgical intensive care units

AAC intervention in the intensive care unit: The children's hospital Boston model

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