• DOI:10.4037/ajcc2011433
• Corpus ID: 22739140

Nurse-patient communication interactions in the intensive care unit.

@article{Happ2011NursepatientCI,
  title={Nurse-patient communication interactions in the intensive care unit.},
  author={Mary Beth Happ and Kathryn L. Garrett and Dana Thomas and Judith A. Tate and Elisabeth L. George and Martin P. Houze and Jill V. Radtke and Susan M. Sereika},
  journal={American journal of critical care : an official publication, American Association of Critical-Care Nurses},
  year={2011},
  volume={20 2},
  pages={
          e28-40
        }
}

• M. Happ, K. Garrett, +5 authors S. Sereika
• Published 1 March 2011
• Medicine
• American journal of critical care : an official publication, American Association of Critical-Care Nurses

BACKGROUND
The inability to speak during critical illness is a source of distress for patients, yet nurse-patient communication in the intensive care unit has not been systematically studied or measured.

OBJECTIVES
To describe communication interactions, methods, and assistive techniques between nurses and nonspeaking critically ill patients in the intensive care unit.

METHODS
Descriptive observational study of the nonintervention/usual care cohort from a larger clinical trial of nurse-patient communication in a medical and a cardiothoracic surgical intensive care unit. Videorecorded interactions between 10 randomly selected nurses (5 per unit) and a convenience sample of 30 critically ill adults (15 per unit) who were awake, responsive, and unable to speak because of respiratory tract intubation were rated for frequency, success, quality, communication methods, and assistive communication techniques. Patients self-rated ease of communication.

RESULTS
Nurses initiated most (86.2%) of the communication exchanges. Mean rate of completed communication exchange was 2.62 exchanges per minute. The most common positive nurse act was making eye contact with the patient. Although communication exchanges were generally (>70%) successful, more than one-third (37.7%) of communications about pain were unsuccessful. Patients rated 40% of the communication sessions with nurses as somewhat difficult to extremely difficult. Assistive communication strategies were uncommon, with little to no use of assistive communication materials (eg, writing supplies, alphabet or word boards).

CONCLUSIONS
Study results highlight specific areas for improvement in communication between nurses and nonspeaking patients in the intensive care unit, particularly in communication about pain and in the use of assistive communication strategies and communication materials.