Communication With Ventilated Patients In ICU: Perceptions On Existing Communication Methods And Needs

Abstract

Introduction: Recent research has highlighted the need to improve communication with mechanically ventilated patients. There are a number of studies currently evaluating the usefulness of augmentative and alternative communication methods (AACs), but a significant gap still exists in understanding patients' key needs during the ventilation period. Aims: 1) To determine the perceptions of patients and healthcare staff on the use of AACs. 2) To find out patients' key needs during ventilator treatment, within the context of Ward 118 in the Royal Infirmary of Edinburgh. 3) To use the results of this study to propose larger scale research into adapting a specific electronic device (Predictable) to aid communication. Methods: This qualitative study adopted semi-structured interviews lasting 10-20 minutes with 13 patients and 18 members of healthcare staff and applied thematic analysis in interpreting interview findings. Results: There was a mismatch between patient and staff perceptions on the usefulness of closed yes/no questions and lip reading. Aided AACs, such as picture boards, pen and paper, and sketch boards are also underused. Most patients and staff used a combination of methods rather than any one method alone. This study also found that patients' key needs include addressing discomfort related to the ventilator, bed or breathing, emotional needs, trust building with healthcare staff and the need for more information. Conclusion: This study highlights the need for personalized, patient-centred care to facilitate effective communication with ventilated patients.

Nurses' communication with mechanically ventilated patients in the intensive care unit: Umbrella review

“…Fourth, our findings show three different AAC approaches may be useful in the ICU: unaided AAC, aided low‐tech AAC, and aided high‐tech AAC. Studies that examined the communication methods used by mechanically ventilated patients reported that unaided approaches mostly encompassed the use of yes/no signals as the dominant strategy and aided AAC was rarely applied (Happ et al., 2011; Sii & Swann, 2015). Unaided AAC may be the dominant approach as mechanically ventilated patients experience a greater level of physical weakness and fatigue and fluctuate in the level of consciousness and/or cognition, thus unable to use advanced AAC (Holm & Dreyer, 2018b; Sii & Swann, 2015).…”

Correlation between nurses' attitude and practice toward communication with patients of decreased level of consciousness and its relationship with ethical care in ICU: A cross‐sectional study

“…They demonstrated the gap in the literature that exists regarding nurses' concerns when it comes to communicating with patients who have a diminished level of consciousness. These circumstances are incompatible with delivering high‐quality, secure, and patient‐centered care 6 . It is highly advised to maintain a positive attitude, be a good listener, and grasp patients' needs by using appropriate skills to improve communication 9,10 along with providing useful and ethical care 11 …”

“…One of the biggest problems for patients with a decreased level of consciousness (DLOC) today is the breakdown in nurse‐patient communication. In ICUs, nurses have a special relationship with patients and play a crucial role in communicating with patients who are unable to speak 6 . According to Holm & Dreyer (2018), communicating with a patient who has a lower level of consciousness revolves around two emotions: frustration and open communication 7 .…”

“…In ICUs, nurses have a special relationship with patients and play a crucial role in communicating with patients who are unable to speak. 6 According to Holm & Dreyer (2018), communicating with a patient who has a lower level of consciousness revolves around two emotions: frustration and open communication. 7 Meanwhile, weak nurse‐patient communication when patients have DLOC was mentioned by Dithole et al 8 as a communication barrier with patients.…”

“…These circumstances are incompatible with delivering high‐quality, secure, and patient‐centered care. 6 It is highly advised to maintain a positive attitude, be a good listener, and grasp patients' needs by using appropriate skills to improve communication 9 , 10 along with providing useful and ethical care. 11 …”