Communication Access in the ICU
April 28, 2020
When a person is admitted to an intensive care unit in a hospital, there is a likely chance that they may require the use of a ventilator and therefore be unable to speak during that time. At a critical point in a person’s life, they may not be able to talk to loved ones or make decisions regarding their own care. In addition, research shows that communication difficulty is associated with increased patient distress, inaccurate symptom assessment, adverse events, and increased use of restraints.
Resources, tools and training are available to support front line staff such as Nurses and Respiratory Therapists to communicate with patients who are on ventilators. A pilot project was initiated in the Intensive Care Unit at St. Paul’s Hospital in Vancouver, B.C., to provide these necessary supports for their staff.
A Speech-Language Pathologist is assigned to work in the ICU and is available to support staff, consult on more complicated situations, maintain the communication tools and coordinate ongoing training opportunities regarding communication. Nurses and Respiratory Therapists are provided with training opportunities during their education days and a link to the SPEACS-2 online training program is provided to them via their intranet system. https://nucleus.con.ohio-state.edu/media/speacs2/project_desc.htm
The Communication Access cart contains resources to support communication.
There are ways to store sensory accommodations such as glasses and hearing aids, and descriptions for how a patient indicates yes and no.
adapted writing supports for hands that are weak,
boards of pictures and letters that a patient can point to,
and pictures of common gestures.
The Communication Care Plan at the head of the bed allows everyone to know how the patient communicates.
The Communication Access Steering Committee consists of Vininder Bains (Clinical Nurse Specialist, St. Paul’s), Mia Marles (Clinical Resource Nurse, St. Paul’s), Susan Bello (Clinical Nurse Educator, St. Paul’s), Tammy Vigliotti (Respiratory Therapist, St. Paul’s), Sheila Lindfield (Patient Advocate, St. Paul’s), Rachel Kennedy (Speech-Language Pathologist, St. Paul’s), Karen Wruck (Speech-Language Pathologist, ATS), and Lois Turner (Speech-Language Pathologist, CAYA).
The committee acknowledges the important contributions of former members, Gail Gumprich (Speech-Language Pathologist, St. Paul’s), Jacob Rowe (Speech-Language Pathologist, ATS) and Sasha Wade (Speech-Language Pathologist, ATS).
This project was completed with the support of Providence Health Care, Vancouver Coastal Health Authority, St Paul’s Foundation, ATS (Assistive Technology Service) at GF Strong Rehabilitation Centre, and CAYA (Communication Assistance for Youth & Adults).
The Communication Access resources used at St Paul’s Hospital can be downloaded at
https://www.cayabc.org/resources/icu/
For information and resources from other organizations, please view the websites listed below. A summary of research done to support the need for improved communication in the intensive care unit can also be found on the SPEACS-2 site.
https://www.patientprovidercommunication.org/
https://nucleus.con.ohio-state.edu/media/speacs2/project_desc.htm
Submitted by:
Karen Wruck (ATS)
Lois Turner (CAYA)
Vancouver, BC