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RES249
New Communication Approaches to a Time Old Problem
By: C. Reed, R. Beadle, M. Sherman, C. Reineck, L. Wammack, S. Gerhardt, N. Larson & I. Fonseca; University Hospital; UTHSCSA SON, TX.
For further information, please contact: Charles.Reed@uhs-sa.com, Reineck@uthscsa.edu
Purpose: Determine educational preparation, values, and frustrations of the health care staff in communication with non-verbal patients in an ICU setting. Secondly, identify patients’ physical, social needs and best method for communication when they were non-verbal.
Background/Significance: Effective communication with non-verbal patients is a challenge for health care staff and patients. Despite working towards a standardized approach to deliver safe and effective care to patients, little has been done to address the issues that arise when attempting to communicate with a non-verbal patient. Often the method for communication is determined by the nurse. Without an algorithm that provides a decision-tree approach, nurses make choices based on prior experience or “trial and error.”
Methods: IRB approval was obtained. A 21 question survey was developed through combination of two published communication surveys. This survey was administered to 63 surgical intensive care nurses. The survey results were used to identify nurses’ present perspectives towards their ability to communicate with their non-verbal patients. 23 patients were interviewed post extubation to evaluate their experiences and feelings while they were unable to communicate with their caregivers. The patient interviews also evaluated the effectiveness of the communication tools used during their non-verbal experience. 18 nurses were interviewed in patients’ post extubation period regarding tools used.
Results: The nursing survey revealed: 75% felt current methods for non- verbal communication were inadequate to meet their patient’s needs, all nurses felt that it was important/very important that the patient be able to communicate, and 30% felt they could effectively understand the patient. In patient post-extubation interviews, 74% reported breathing, pain and fear as the greatest physical discomfort, 31% reported the inability to talk was greatest social problem, 59% were extremely frustrated with inability to communicate and 42% wanted more information on health status. 70% of patients were able to communicate needs through writing, hand gestures, mouthing, and electronic communication board.
Conclusions: To decrease that frustration and allow for the delivery of safe and effective patient care, emphasis needs to be placed on using a communication method algorithm, formal training for the nurses, patient debriefing post-extubation, and availability of various tools for non-verbal communication.
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