Nurse and Patient Interaction Behaviors’ Effects on Nursing Care Quality for Mechanically Ventilated Older Adults in the ICU

Abstract

The study purposes were to 1) describe interaction behaviors and factors that may impact communication and 2) explore associations between interaction behaviors and nursing care quality indicators between 38 mechanically ventilated patients (≥60 years) and their intensive care unit nurses (n=24). Behaviors were measured by rating videotaped observations from the Study of Patient-Nurse Effectiveness with Communication Strategies (SPEACS). Characteristics and quality indicators were obtained from the SPEACS dataset and medical chart abstraction. All positive behaviors occurred at least once. Significant (p<.05) associations were observed between: 1) positive nurse and positive patient behaviors, 2) patient unaided augmentative and alternative communication (AAC) strategies and positive nurse behaviors, 3) individual patient unaided AAC strategies and individual nurse positive behaviors and 4) positive nurse behaviors and pain management, and 5) positive patient behaviors and sedation level. Findings provide evidence that nurse and patient behaviors impact communication and may be associated with nursing care quality.

Which alternative communication methods are effective for voiceless patients in Intensive Care Units? A systematic review

“…Table 3 details the AAC interventions with high-technology computer-aided AAC strategies (Happ et al, 2004b;Happ et al, 2005; Rodriguez et al, 2016), ease or difficulties in communication (Happ et al, 2004b;Happ et al, 2005;Happ et al, 2014;Maringelli et al, 2013;Otuzoglu & Karahan, 2014;Rodriguez & Rowe, 2010, Rodriguez et al, 2016, communication success or effectiveness (Happ et al, 2014;Happ et al, 2016), initiation of communication (Happ et al, 2005), staff satisfaction (Maringelli et al, 2013;Miglietta et al, 2004), patient agitation and anxiety (Happ et al, 2016) and barriers to use (Happ et al, 2004b;Happ et al, 2014;Rodriguez et al, 2010;Rodriguez & Rowe, 2012). A variety of study designs were used which included some described as randomised controlled trials (RCT) (El-Soussi et al, 2014), randomised cluster trials (Happ et al, 2015), quasi-experimental (Happ et al, 2014;Otuzoglu & Karahan, 2014, Rodriguez et al, 2016, correlational (Nilsen et al, 2014), time-series (Rodriguez & Rowe, 2010) to pilot/feasibility studies (Happ et al, 2004b;Happ et al, 2005;Maringelli et al, 2013;Miglietta et al, 2004;Rodriguez et al, 2012). The studies described as randomised trials (El-Soussi et al, 2014;Happ et al, 2016) were treated as controlled or cohort analytic trials as the reported randomisation process was unclear.…”

“…The included studies used a variety of AAC strategies but a meta-analysis to compare data across studies was not appropriate due to the heterogeneity of study designs and outcomes measures. The AAC strategies that were used were reported to reduce difficulty in communication (Happ et al, 2004b;Happ et al, 2005;Happ et al, 2014;Maringelli et al, 2013;Otuzoglu & Karahan, 2014), improve patient satisfaction in communication (El-Soussi et al, 2014;Miglietta et al, 2004;Rodriguez & Rowe, 2010;Rodriguez et al, 2012;Rodriguez et al, 2016), reduce patient frustration in communication (Rodriguez et al, 2016), increase communication interactions (Happ et al, 2014) and increase positive nurse behaviours such as smiling or giving preparatory information before a procedure (Nilsen et al, 2014).…”

“…Five studies used low technology AAC strategies for at least one of the intervention groups (El-Soussi et al, 2014;Happ et al, 2014;Happ et al, 2016;Nilsen et al, 2014;Otuzoglu & Karahan, 2014). Comparison between the two different types of AAC strategies was not attempted in Nilsen et al (2014) and although the count of different AAC strategies was positively correlated with positive nurse behaviours (F = 9.93, p = 0.002), the results cannot be included in any comparison. Happ et al (2014) measured ease of communication using a Likert scale from "not difficult at all" to "extremely difficult" at the end of observed session throughout the same three phase study.…”

Basic Life Skills Required by Girl-Children to Overcome Adversities of Polygamy in Etsako Nigeria

“…The uses of verbal and nonverbal interaction behaviors facilitate synergistic relationship (Nilsen et al, 2014). Good communication actually consists of many different sub-skills, from appropriate patterns of body language and eye contact to the ability to write clearly and accurately.…”

“…Accurate listening and the ability to follow instructions are especially important but are often ignored or taken for granted. Changes and environmental factors can contribute to communication breakdowns, misunderstandings, and difficulty recalling (Nilsen et al, 2014). …”