Abstract
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.
Keywords
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References
- The lived experiences of adult intensive care patients who were conscious during mechanical ventilation: a phenomenological-hermeneutic study.Intensive Crit Care Nurs. 2012; 28: 6-15
- Communication difficulties and psychoemotional distress in patients receiving mechanical ventilation.Am J Crit Care. 2011; 20: 470-479
- Patients' recollections of stressful experiences while receiving prolonged mechanical ventilation in an intensive care unit.Crit Care Med. 2002; 30: 746-752
- The symptom burden of chronic critical illness.Crit Care Med. 2004; 32: 1527-1534
- Nonvocal ventilated patients perceptions of being understood.West J Nurs Res. 2004; 26 (Discussion 4–12): 85-103
- Factors related to the emotional responses of intubated patients to being unable to speak.Heart Lung. 1998; 27: 245-252
- New and Revised Standards and EPs for Patient-Center Communication- Hospital Accreditation Program.2010 (Available at) (Accessed 23.07.10)
- AAC intervention in the intensive care unit: the children's hospital Boston model.AAC Augment Altern Commun. 2000; 16: 137-153
- Electronic voice-output communication aids for temporarily nonspeaking patients in a medical intensive care unit: a feasibility study.Heart Lung. 2004; 33: 92-101
- Nurses' perceptions of communication training in the ICU.Intensive Crit Care Nurs. 2012; 28: 16-25
- Listening to the voiceless patient: case reports in assisted communication in the intensive care unit.J Palliat Med. 2011; 14: 791-795
- Comparison of two types of communication methods used after cardiac surgery with patients with endotracheal tubes.Heart Lung. 1988; 17: 281-289
- Augmentative Communication Strategies for Adults with Acute or Chronic Medical Conditions.Paul H Brookes Publishing Co., Baltimore, MD2007
- Effect of a multi-level intervention on nurse-patient communication in the intensive care unit: results of the SPEACS trial.Heart Lung. 2014; 43: 89-98
- SPEACS-2: intensive care unit “communication rounds” with speech language pathology.Geriatr Nurs. 2010; 31: 170-177
- The medical archival system: an information retrieval system based on distributed parallel processing.Inf Process Manage. 1991; 27: 379-389
- Assessment of coma and impaired consciousness. A practical scale.Lancet. 1974; 2: 81-84
- Prospective evaluation of the sedation-agitation scale for adult critically ill patients.Crit Care Med. 1999; 27: 1325-1329
- Controlled sedation with alphaxalone-alphadolone.Br Med J. 1974; 2: 656-659
- Patients' reports of health care practitioner interventions that are related to communication during mechanical ventilation.Heart Lung. 2004; 33: 308-320
- Prevalence of sudden speechlessness in critical care units.Clin Nurs Res. 2011; 20: 439-447
- A demographic study of AAC/AT needs in hospitalized patients.Perspect Augment Altern Commun. 2013; 22: 79-90
- The epidemiology of mechanical ventilation use in the United States.Crit Care Med. 2010; 38: 1947-1953
- Reducing iatrogenic risks: ICU-acquired delirium and weakness–crossing the quality chasm.Chest. 2010; 138: 1224-1233
- Long-term cognitive and psychological outcomes in the awakening and breathing controlled trial.Am J Respir Crit Care Med. 2010; 182: 183-191
- The bedside diagnosis of ICU delirium: specificity is high, let's optimize sensitivity.Am J Respir Crit Care Med. 2012; 185 (Author reply 8): 107-108
- AAC in intensive care units.in: Buekelman D.R. Garrett K. Yorkston K.M. Augmentative Communication Strategies for Adults with Acute or Chronic Medical Conditions. Brookes Publishing Company, Baltimore, MD2007
- Promoting effective communication for patients receiving mechanical ventilation.Crit Care Nurse. 2011; 31: 46-60
The Joint Commission. Advancing effective communication, cultural competence, and patient- and family-centered Care: A roadmap for Hospitals. http://www.jointcommission.org/assets/1/6/ARoadmapforHospitalsfinalversion727.pdf2010.
Article info
Publication history
Published online: September 25, 2014
Accepted:
August 30,
2014
Received in revised form:
August 29,
2014
Received:
July 7,
2014
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
