Patient-Nurse Effectiveness with Assistive Communication Strategies (SPEACS): Role in Frustration, Communication and Avoidance in ICU
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Date
2021-05
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The Ohio State University
Abstract
Purpose and Background/Significance: Prior to the COVID-19 pandemic, there were over 900,000 hospital admissions for respiratory failure and invasive mechanical ventilation (MV) in the US annually. Communication difficulty is associated with severe emotional distress among MV patients. Nurses report frustration with and avoidance of MV patients with whom communication is difficult. The SPEACS-2 program (Study of Patient-nurse Effectiveness with Assistive Communication Strategies) provides online training and toolkit to improve nurse communication skills by teaching effective assessment and augmentative and alternative communication (AAC) strategies. This study applied novel measures of student nurse and ICU nurse feelings of frustration and avoidance toward interactions with MV patients before and after SPEACS-2 training.
Theoretical Framework: The study was guided by the "nurse-patient communication model" (Happ et al, 2008), informed by communication disorders science and AAC research and practice.
Aims: Among nurses and student nurses participating in SPEACS-2 training, (1) determine the relationship between frustration with communication and avoiding contact with patients who are difficult to understand; (2) describe the change in frustration with communication and avoiding contact with patients after SPEACS-2 training relative to before (nurses only); and (3) determine differences between nurse and student nurse groups in frustration with communication and avoidance of contact with patients after SPEACS-2 training.
Method: We conducted a descriptive, comparative secondary analysis of Nurse Communication Survey (NCS) data collected in two separate studies with ICU nurses and pre-licensure nursing students. The NCS is a 16-item survey measuring nurse comfort and satisfaction communicating with MV patients in ICU. Individual NCS items measure frustration with communication and avoidance.
Results: 263 ICU nurses and 85 student nurses participated in the survey. Findings suggest a weak positive correlation between avoidance and frustration variables (0.302 (p<0.0001). The ICU nurse group showed a significant change post-intervention in feeling frustrated (p =0.0001) but no change in avoidance. There was a significant difference between nurse and student nurse groups in frustration (p<0.0001) and avoidance (p=0.0027).
Conclusions: The significant reduction in nurse and student nurse frustration as a result of this communication training intervention may translate into greater nurse satisfaction and better patient experience.
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Keywords
patient-nurse communication, intensive care unit, mechanical ventilation, communication difficulty