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Updated: Aug 7, 2026
Assessment and Communication for People with Disorders of Consciousness
Published on: August 1, 2017
Development and Validation of an ICU Communication Checklist for Conscious Patients With Artificial Airways: Evidence
Jie Gong1, Jiayuan Feng1,2, Yusu Li1
1Department of Intensive Care Unit, The Second Affiliated Hospital of Soochow University, Suzhou, China.
Background:
Conscious ICU patients with artificial airways experience severe communication difficulties and psychological distress. Despite international consensus on effective communication elements, no synthesised evidence-based guideline or content-validated checklist exists for this population. In Chinese ICUs, where nurses lead bedside communication, standardised tools remain urgently needed.
Aim:
To develop and content-validate an evidence-based communication management checklist for conscious ICU patients with artificial airways through best evidence synthesis and nominal group technique (NGT).
Study Design:
A two-phase study comprising best evidence synthesis and NGT was conducted in China. Systematic searches across 16 databases and guideline repositories were performed from May 2014 to April 2025. Evidence quality was appraised using JBI tools, graded according to JBI Grades of Evidence, and recommendation strength was determined using the FAME framework. Nine ICU nursing experts (mean ICU experience 18.6 ± 4.2 years) reached consensus through two rounds of face-to-face meetings. Content validity was assessed using item-level and scale-level Content Validity Index.
Results:
Of 328 records identified, 16 studies were included. Twenty-five evidence items were synthesised across five domains. Through two rounds of expert consensus, these were refined into a 16-item checklist across four domains: training and incentive mechanisms, provision of communication tools, communication implementation and outcome evaluation. The final checklist demonstrated satisfactory content validity (S-CVI/Ave = 0.95; S-CVI/UA = 0.81).
Conclusions:
An evidence-based, expert consensus communication management checklist with established content validity was successfully developed for conscious ICU patients with artificial airways. Further validation of clinical effectiveness is warranted.
Relevance To Clinical Practice:
This content-validated checklist provides structured guidance for clinical communication management, addressing the critical gap in standardised protocols for this vulnerable population.
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