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

Abstract

Aim: To conduct a review summarizing evidence concerning communication with mechanically ventilated patients in the intensive care unit (ICU). Background: ICU patients undergoing mechanical ventilation are unable to communicate verbally, causing many negative emotions. Due to changes in sedation practice, a growing number of patients are conscious and experience communication difficulties. Design: The umbrella review method guided by the Joanna Briggs Institute was applied.

Nurses’ experiences of serving as a communication guide and supporting the implementation of a communication intervention in the intensive care unit

“…The patient is trapped in a voiceless world where the expression of thoughts, wishes, needs and concerns depends on the nurse’s ability to interpret his or her nonverbal communication (Carroll, 2007 ; Danielis et al, 2020 ; Karlsson et al, 2012 ). Nurse-patient communication in the ICU is affected by multiple factors; 1) the patients’ communicative characteristics and general condition, which may vary from day to day; 2) the nurses’ communication approach and care focus; 3) the relation between the nurse and patient; and 4) external factors, e.g., pressure from busyness, the ICU environment and strategies implemented to promote communication (Dithole et al, 2016 ; Finke et al, 2008 ; Anna Holm et al, 2020 ). Difficult or failed communication is frustrating for nurses and patients alike (A. Holm & Dreyer, 2018 ).…”

“…Moreover, it affects nurses’ experiences of professionalism and job satisfaction (Freeman-Sanderson et al, 2019 ; IJssennagger et al, 2018 ; Rodriguez et al, 2015 ). Several research syntheses have shown that numerous studies have been conducted to optimize communication for mechanically ventilated patients; they have also established that ICU nurses are the gatekeepers for this to succeed (Carruthers et al, 2017 ; Dithole et al, 2016 ; Anna Holm et al, 2020 ; Karlsen et al, 2019 ; ten Hoorn et al, 2016 ). However, implementation of interventions in clinical practice is known to be notoriously difficult (Hallberg & Richards, 2015 ), which is also the case in the ICU setting (Bjurling-Sjöberg et al, 2018 ; Bjurling‐Sjöberg et al, 2015 ; Handberg & Voss, 2018 ).…”

Approach to the basic needs in patients on invasive ventilation using eye‐tracking devices for non‐verbal communication

“…Impaired communication is considered to be the predominant problem of intubated and invasively ventilated patients in the ICU, and it is even suggested to be the major limitation in daily care routines. 1,36,37 A variety of AAC methods are available and may be of prime importance to enable communication in ICU patients. [9][10][11][12][13][14][15] There is growing evidence that communication interventions with intubated and invasively ventilated ICU patients are feasible, have utility, and are safe, but there is no agreement on the most effective AAC tool.…”

“…Impaired communication is considered to be the predominant problem of intubated and invasively ventilated patients in the ICU, and it is even suggested to be the major limitation in daily care routines 1,36,37 . A variety of AAC methods are available and may be of prime importance to enable communication in ICU patients 9–15 …”

<br> MÉTODOS DE COMUNICAÇÃO EFICAZES APLICADOS À PESSOA VENTILADA EM UNIDADE DE CUIDADOS INTENSIVOS: Revisão Sistemática da Literatura </br>

“…A ventilação mecânica invasiva (VMI) tem como benefício proteger os pulmões do doente, fornecendo ventilação e oxigenação até à eliminação das causas subjacentes. Esta técnica, provoca, contudo, incapacidade de comunicar verbalmente devido à entubação endotraqueal ou traqueostomia que ocasiona perda de voz por um determinado período de tempo (3,4) . Na prática clínica de enfermagem, a comunicação é um elemento essencial, na medida em que é através da relação enfermeiro-doente que se consegue compreender profundamente as necessidades físicas e emocionais inerentes ao estado de saúde da pessoa (5) .…”