Standardized nursing handoff sheet for new graduates

COMMUNICATING WITH VENTILATED PATIENTS 1

COMMUNICATING WITH VENTILATED PATIENTS 2

Communicating with Ventilated Patients

Student’s Name

Date

Communicating with Ventilated Patients

Introduction

It may be hard to communicate with patients under mechanical ventilation as a member of an inter-professional team offering care. Ventilated patients are unable to communicate because of the presence of the endotracheal tube (ETT). However, such communication is important to ensure patient safety and comfort since patients under such conditions usually experience panic, anxiety, fear, pain, and dyspnea, among other types of discomfort. Furthermore, despite their conditions, mechanically ventilated patients desire and have the right to be heard and take part in the making of decisions on their health for the attainment of patient-centered care.

               This topic is important to contribute to the area of nursing to limit the gap of knowledge regarding relevant methods and strategies of communication for proper communication with ventilated patients. Research reveals that the care process for ventilated patients is undermined when there is a lack of communication between the patient and the caregivers. The presence of a communication barrier coupled with the health issue put the patients in a state of hopelessness. Identifying relevant communication methods for communicating with ventilated patients is important to eliminate feelings of fear, pain, and insecurity over the severity of their conditions.

 Additionally, the identification of such communication methods will be useful towards the attainment of positive care outcomes in health care organizations that provide intensive care to critically ill patients. Organizations that consider such communication are bound to stand out as the leading in quality health care providers within their locales. Proper communication with ventilated patients will contribute to the research and study of the experiences of patients under mechanical ventilation and will enhance evidence-based care for such patients.

Literature Review (Topic)

               Over the years, scholars and professionals in the healthcare industry have researched the issue of communicating with ventilated patients. One such research is documented in The Ventilated Patient’s Experience, which seeks to find out if there exists a relationship between the use of effective communication tools with ventilated patients with satisfaction with care among the patient and family (Fink, Makic, Poteet and Oman, 2015). The authors of the article indicate that anxiety, pain, and fear are some of the emotions that patients under mechanical ventilation have to deal with.

Furthermore, upon recovery, these patients deal with traumatic memories that may be realistic, delusional, or emotional. Such memories of their time in intensive care place the patients at risk of psychological problems and post-traumatic stress disorder (PTSD) that may linger for as long as they live affecting their quality of life. According to the authors, the emotional pain that was reported most among adult trauma patients’ emotional memories was pain, followed by frustration and anxiety (Fink, Makic, Poteet and Oman, 2015). The loss of ability to communicate leaves ventilated patients feeling powerless and out of control of their situation. There is a need for optimal communication methods and strategies to limit the stress and anxiety of ventilated patients.

Another research is one by Aziza Salem and Muayyad Ahmad, who attempt to find out the issues related to ventilated patient communication (Salem and Ahmad, 2018). The authors aim to contribute to the development of relevant communication strategies and methods for effective communication with patients under mechanical ventilation. A major concern for nurses in inter-professional teams is how to communicate with such patients.

The research reveals that similar to other patients, ventilated patients desire to take part in the process of their care and the communication barrier in form of ETT makes them perceive that they have lost control over their treatment and they end up feeling frustrated (Salem and Ahmad, 2018). Nurses spend limited time when interacting with patients in intensive care and this revealed that there is ineffective communication between such patients and their caregivers. Over 60% of patients indicate that they desired to know about their health progress while under ventilation (Salem and Ahmad, 2018). The article reveals the need for effective communication with these patients as it promotes patient recovery by bringing about a sense of safety and security.

Literature Review (Solution)

               Hoom, Elbers, Girbes, and Tuinman (2016) acknowledge the communication issue that arises when caring for patients who are ventilator dependent because of intubation. According to the authors, various assistive communication tools being in place but they are not often used on patients under intensive care (Hoorn, Elbers, Girbes and Tuinman, 2016). The article acknowledges the relationship between ineffective communication with severe emotional reactions among ventilated patients.

This article is relevant to solving the issue of communicating with ventilated patients as it offers an algorithm that standardizes the approach of choosing the relevant augmentative and alternative (AAC) methods. According to the article, AAC represents forms of communication that are not limited to oral speech that express messages (Hoorn, Elbers, Girbes and Tuinman, 2016). One of the communication techniques offered in the article is communication boards made up of icons and pictures to represent basic needs (Hoorn, Elbers, Girbes and Tuinman, 2016). Other communication strategies include; the use of a speaking tracheotomy tube with an inflated cuff, the use of electro larynx, and high-tech communication intervention.

               A solution for the ineffective communication between ventilated patients and the nurses offering them care is the use of communication devices (Zaga, Berney and Vogel, 2019). One of the relevant communication devices for these patients is a picture board, which contains pictures of the basic needs the patient might want. According to Zaga, Berney and Vogel (2019), picture boards ease the level of frustration among ventilated patients. To further improve the quality of care for patients under intensive care, nurses should pass on relevant communication techniques in their reports when exchanging shifts. 

Research indicates that the use of the Critical care Pain Observation Tool (CPOT) has been shown to improve pain assessment and management for ventilated patients (Zaga, Berney and Vogel, 2019). Furthermore, the use of AAC should be planned rather than unplanned for patient satisfaction with care. Zaga, Berney and Vogel (2019) indicate that the use of communication strategies and methods is important and beneficial towards the improvement of patient care and outcomes overall. As a result, nurses should be educated on the need for communication with ventilated patients and the negative impacts of lack of communication with these patients. Additionally, nurses should be educated on how to make use of AAC to facilitate effective communication with patients who cannot talk because of being mechanically ventilated. 

Implementation

               Effective communication with ventilated patients requires sensitivity towards the need for effective communication with these patients and the communication strategies and tools that make it possible. A health care organization can organize a teaching intervention for nurses, which they will attend in their time off work. These interventions will be aimed at teaching nurses the need for communication with patients under intensive care and how to use the tools and strategies in place to enhance communication between them and these patients. The intervention will be done in two segments, where the first will involve sessions that will handle the need for effective communication with ventilated patients while the second will have sessions to handle the use of communication strategies and tools.

This intervention will take approximately two weeks to complete and nurses will be grouped according to the shifts they will be handling in the two weeks. This teaching intervention will be important towards the attainment of effective communication with ventilated patients and will consequently improve the patient care process and outcomes. Teaching nurses to use communication strategies and methods for effective communication with patients will promote the reputation of the health care organization as one that offers quality care regardless of the situation. At the end of the intervention, the nurses will be better equipped to care for patients who are unable to communicate orally because of being mechanically ventilated.

The patients under critical care will be less emotionally stressed and will regain control of the care process for their health. Consequently, the hospital will have attained the universal health care goal of patient-centered goal. In this case, an evaluation will involve analyzing the length of hospital stay for critically ill patients because effective communication with such patients is bound to limit it. Moreover, the evaluation will involve analysis of ventilated patients’ emotional reactions while receiving care. On the other hand, the relevant follow-up will involve research into the improvements and developments made in terms of communication strategies and methods for communicating with ventilated patients and incorporating them into the existing strategies and methods.

References

Fink, R. M., Makic, M. B. F., Poteet, A. W., & Oman, K. S. (2015). The ventilated patient’s experience. Dimensions of Critical Care Nursing, 34(5), 301-308.

Salem, A., & Ahmad, M. M. (2018). Communication with invasive mechanically ventilated patients and the use of alternative devices: integrative review. Journal of Research in Nursing, 23(7), 614-630.

Ten Hoorn, S., Elbers, P. W., Girbes, A. R., & Tuinman, P. R. (2016). Communicating with conscious and mechanically ventilated critically ill patients: a systematic review. Critical Care, 20(1), 1-14.

Zaga, C. J., Berney, S., & Vogel, A. P. (2019). The feasibility, utility, and safety of communication interventions with mechanically ventilated intensive care unit patients: A systematic review. American journal of speech-language pathology, 28(3), 1335-1355.