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Opportunities for Interactive Communication in Mechanically Ventilated Critically Ill Patients: A Video-Based
Akiko Yamaguchi1, Atsue Ishii1, Haruna Fukushige1
1Department of Nursing, Graduate School of Health Sciences, Kobe University, 7-10-2 Tomogaoka, Suma-ku, Kobe, Hyogo 654-0142, Japan.
Nursing Research and Practice
|July 25, 2022
Summary
Critically ill patients on mechanical ventilation often lack communication opportunities. Nurses should proactively initiate communication and respond to patient-initiated actions to improve patient care.
Area of Science:
- Nursing
- Critical Care Medicine
- Patient Communication
Background:
- Mechanically ventilated patients in critical care settings face significant communication barriers.
- Effective communication is vital for addressing physical and psychosocial needs of these patients.
Purpose of the Study:
- To characterize communication opportunities between nurses and critically ill, mechanically ventilated patients.
- To identify patterns in nurse-patient communication initiation and patient-expressed intent.
Main Methods:
- A video-based, descriptive observational study design.
- Inclusion of seven conscious, mechanically ventilated patients and seven registered nurses.
- Continuous video recording and descriptive analysis of interactions over an 8-hour period.
Main Results:
- Two-way communication occurred for 78 minutes out of 668 minutes of observation.
- Nurses initiated communication more frequently (47.2 minutes) than patients (24.2 minutes).
- Patients used 'Patient-Intentional-Action' (e.g., upper limb movements, gestures) to initiate communication.
Conclusions:
- Nurses play a crucial role in creating communication opportunities by initiating interactions and responding to patient cues.
- Recognizing and responding to 'Patient-Intentional-Action' is essential for facilitating patient communication.
- Proactive nursing communication is recommended over passively waiting for patient initiation.
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