INQRI Funded Study: More than Half of Ventilated ICU Patients Have Ability to Communicate

Assistive communication tools could benefit more than half of patients in intensive care units (ICU) who are using ventilators to help them breathe, according to a new study co-funded by the INQRI program.

“Our findings challenge the commonly held assumption of many clinicians and researchers that these patients are unable to communicate or participate in their care,” INQRI grantee and study co-author Mary Beth Happ said in a statement. Happ is a professor of nursing at The Ohio State University.

The study found that 53.9 percent of the patients screened met basic communication criteria and could possibly benefit from the use of assistive communication tools and speech language consultation, including such simple tools as notepads and pens.

“Establishing lines of communication is the first step in a patient being able to make his or her needs known and have accurate symptom assessment and management, and contributes to an overall better patient experience. We know from interviews with patients who remember their critical care experience that the inability to communicate is anxiety producing and, in some cases, terrifying,” said Happ.

The study, which involved screening nearly 3,000 mechanically ventilated patients over a two year period, appears in the January/February 2015 issue of the journal Heart & Lung and is co-authored with Happ’s colleagues from the University of Pittsburgh. The study is co-funded by the National Institutes of Health.


Happ’s previous INQRI work includes the study “SPEACS2: Improving Patient Communication and Quality Outcomes in the ICU,” which examined the value of a nurse-generated and nurse-led innovation by testing the impact of a computer-based nurse communication training and materials program (SPEACS-2) on intensive care unit patient care outcomes. The interdisciplinary research team included Amber Barnato, who also co-authors Happ’s current research.

Nurse Intervention Beneficial to Patients Dealing with Chronic Pain

Nurses can help lead efforts to ease psychological distress and reduce suffering for people with chronic pain, according to a new study of U.S. veterans.

Nurse care managers in the study provided support, motivation, and encouragement that “many of the participants really clung to,” lead author Marianne Matthias tells Pain Medicine News. Nurses were also very important in providing cognitive-behavioral therapy (CBT) to the veterans.

Matthias’s paper is one of several being published from the Evaluation of Stepped Care for Chronic Pain (ESCAPE) study, which involved 242 U.S. veterans of the recent Afghanistan and Iraq wars. The study was funded by the Department of Veterans Affairs. In 2010, a U.S. Army Pain Management Task Force made recommendations on the best approach to helping veterans with chronic pain, which included making support available and creating a spectrum of best evidence-based practices for the continuum of care. The ESCAPE studies were conducted in response to those recommendations.

For Matthias’s study, patients were put into randomized groups to either receive “usual care” or “a nurse-led intervention” that included pain medication management and 12 phone conversations. During the conversations nurses provided information on medication management, pain self-management instruction, and CBT. The most recent findings from the study, which explored the pain’s emotional toll on 26 patients and their perceptions of need for support, found that nurses in particular had a positive impact on the patients.

An INQRI funded study: SPEACS 2: Improving Patient Communication and Quality Outcomes in the ICU, examined the value of a nurse-generated and nurse-led innovation on ICU patient care outcomes, including pain symptom management. The study was led by Mary Beth Happ and Amber Barnato.

INQRI Project Provides New Online Communication Tools to Improve ICU Patient Care

ICU patients who can’t communicate because they are ventilated or using artificial airways can become anxious, frustrated and possibly even panic, putting them at risk for adverse events. Now, new evidence-based online training materials are available to help nurses and other health care providers communicate with these patients.

An interdisciplinary research team funded by INQRI developed and tested SPEACS-2 (Study of Patient-Nurse Effectiveness with Assisted Communication Strategies), a program that includes web-based communications training for nurses, resources to use with patients, and bedside teaching rounds provided by a speech pathologist. The program improves nurses’ knowledge of, comfort with, and satisfaction communicating with mechanically ventilated patients. It also helps patients avoid the frustration and stress of being unable to communicate.

Now the SPEACS-2 communications training program is available online. It consists of tools, resources, and six ten-minute interactive learning modules, which include:

• Introduction to the SPEACS-2 program and assessment to determine how best to use the communications strategies and tools;
• Techniques to help patients better understand questions and instructions, assessing patients’ ability to communicate and establishing communications with patients;
• Techniques to help patients who are cognitively impaired understand and communicate;
• Techniques to better support and understand patients’ “unaided” communications, such as gestures or mouthing words;
• Techniques and materials to assess and support patients’ written communications; and
• Demonstrations of communications strategies to use with patients with impaired movement or attention, and a presentation of the role of a speech language pathologist in assisting with communication.

The INQRI-funded research team that developed and tested SPEACS-2 was led by Mary Beth Happ and Amber Barnato. The study was conducted at the University of Pittsburgh.