Nurses' communication with mechanically ventilated patients in the intensive care unit: Umbrella review
Anna Holm, Anette Viftrup, Veronika Karlsson, Lone Nikolajsen, Pia Dreyer
Abstract
AIM: To conduct a review summarizing evidence concerning communication with mechanically ventilated patients in the intensive care unit (ICU). BACKGROUND: ICU patients undergoing mechanical ventilation are unable to communicate verbally, causing many negative emotions. Due to changes in sedation practice, a growing number of patients are conscious and experience communication difficulties. DESIGN: The umbrella review method guided by the Joanna Briggs Institute was applied. DATA SOURCES: A systematic search was done in the Cochrane Library, the Joanna Briggs Institute database, Cinahl, Pubmed, PsycINFO and Scopus between January -April 2019. Search terms were 'nurse-patient communication', 'mechanical ventilation', 'intensive care', and 'reviews as publication type'. Literature from 2009-2019 was included. REVIEW METHODS: Following recommendations by the Joanna Briggs Institute, a quality appraisal, data extraction, and synthesis were done. RESULTS: Seven research syntheses were included. There were two main themes and six subthemes: (1) Characterization of the nurse-patient communication: (a) Patients' communication; (b) Nurses' communication; (2) Nursing interventions that facilitate communication: (a) Communication assessment and documentation; (b) Communication methods and approaches; (c) Education and training of nurses; and (d) Augmentative and alternative communication. CONCLUSION: Nurse-patient communication was characterized by an unequal power relationship with a common experience - frustration. Four key interventions were identified and an integration of these may be key to designing and implementing future ICU communication packages. IMPACT: Nurse-patient communication is characterized by an unequal power relationship with one joint experience - frustration. Four key interventions should be integrated when designing and implementing communication packages in the ICU. Findings are transferable to ICU practices where patients are conscious and experience communication difficulties.