Summary
Objective: To describe the experience and perceptions of nurse study participants regarding
a communication intervention (training and communication tools) for use with nonspeaking,
critically ill patients.
Research methodology/design: Small focus groups and an individual interview were conducted
with six critical care nurses. Transcripts were analysed using qualitative content analysis and
constant comparison.
Setting: Two ICUs within a large, metropolitan medical centre in western Pennsylvania, United
States of America.
Main outcome measures: Critical care nurses’ evaluations of (1) a basic communication skills
training programme (BCST) and (2) augmentative and alternative communication strategies
(AAC) introduced during their study participation.
Results: Six main categories were identified in the data: (1) communication value/perceived
competence; (2) communication intention; (3) benefits of training; (4) barriers to implementation;
(5) preferences/utilisation of strategies; and 6) leading-following. Perceived value of and
individual competence in communication with nonspeaking patients varied. Nurses prioritised
communication about physical needs, but recognised complexity of other intended patient messages.
Nurses evaluated the BCST as helpful in reinforcing basic communication strategies and
found several new strategies effective. Advanced strategies received mixed reviews. Primary
barriers to practise integration included patients’ mental status, time constraints, and the small
proportion of nurses trained or knowledgeable about best patient communication practices in
the ICU.
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