None listed
Conditions
Brief summary
Patients who are mechanically ventilated in the intensive care unit (ICU) have a temporary loss of voice due to intubation. This causes communication difficulties for both the patients and the healthcare staff involved in their treatment and care. The aim of this pilot randomised controlled trial is to evaluate the feasibility of undertaking a definitive trial of a communication board to be used with mechanically ventilated patients in ICUs. The communication board illustrates patients’ physical, psychological, social, and spiritual needs using related pictures and words in Sinhala. Participants will be randomised to receive either the communication board or the routine communication practices such as hand gestures, pen and paper used in the ICU and followed one week after the recruitment. The primary outcome of this study is feasibility in terms of recruitment, retention, and intervention fidelity related to intervention (communication board) usage. Secondary outcomes will be ease of communication, level of anxiety, level of satisfaction with communication, and experienced acceptability of the communication board. We hypothesise that implementing the communication board will be feasible in terms of recruitment, retention, and intervention fidelity and acceptable as perceived by participants.
Interventions
The intervention is a communication board that illustrates patients’ physical, psychological, social, and spiritual needs using pictures and words in Sinhala. It is a one-sided laminated piece of cardboard that is lightweight and A3 in size. A marker pen can be used for additional communication support, such as pointing out pictures or words on the communication board. The communication board to be implemented is an adjunct to standard care which includes hand gestures, head nodding, and pen and
The intervention is a communication board that illustrates patients’ physical, psychological, social, and spiritual needs using pictures and words in Sinhala. It is a one-sided laminated piece of cardboard that is lightweight and A3 in size. A marker pen can be used for additional communication support, such as pointing out pictures or words on the communication board. The communication board to be implemented is an adjunct to standard care which includes hand gestures, head nodding, and pen and paper, with participants randomised to the intervention group receiving the communication board during their ICU stay. As part of the initial implementation, 15-minute training sessions on how to use the communication board will be conducted for all nurses in both medical and surgical ICUs (four nurses per group) by the principal investigator. The principal investigator is a registered nurse with experience working in highly complex clinical environments. Training sessions for the ICU nursing staff will be conducted prior to recruitment and throughout the study as required. After randomisation, communication boards will be given to each patient who is randomised to the intervention group and will be hung on their beds. Trained ICU nursing staff will take the board to the patients' bedside, familiarise the patient with the content of the communication board and give the patient a marker pen to point out or mark the pictures or words on the board that reflects what the patient is trying to communicate. Nursing staff will be encouraged to use the communication board when the intervention group patients are trying to communicate with the nurses. We anticipate this will occur at least three times each day and will involve about 3-5 minutes of interval with the board. They will be advised to wipe the communication board using a surgical spirit swab as necessary. The patients will be closely monitored for any intervention effects (e.g. becoming fatigued) during the study, as they will be followed up until the study endpoints (i.e. one week after the recruitment). If ICU nursing staff are found to be distressed with using the communication board with patients due to time constraints, a heavy workload, or patient priorities, they will be able to choose not to use the communication board and will be encouraged to contact the principal investigator. Scheduled daily observations will be conducted by the principal investigator to assess compliance with the communication board’s use, and this will be recorded in the intervention fidelity log. Further, the principal investigator will assess each patient in the trial (both intervention and control groups) from Monday to Friday to determine if they are receiving the communication board. Nurses will be regularly reminded to use the communication board for only the intervention group patients.
Sponsors
Griffith University
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients: 1. Equal or more than 18 years of age 2. Mechanically ventilated for at least 4 hours 3. Responsive to verbal stimuli 4. Able to understand Sinhala language 5. Richmond Agitation Sedation Scale score -1 to +1
Exclusion criteria
1. Unconscious patients 2. Palliative care patients 3. Patients with visual and/or hearing impairment
Outcome results
None listed