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A systematic review of the effectiveness of nurse communication with patients with complex communication needs with a focus on the use of augmentative and alternative communication (summary)

Communication
between
nurses
 
and
patients
with
complex
communication
needs

Background

Nurses work in a wide variety of healthcare settings and with a wide range of patients, many of whom might have severely impaired communication skills, either temporarily or permanently, and who might benefit from communication support.

Effective nurse-patient communication is very important in efficient care provision but nurses typically receive very little education or training in the use of supportive communication strategies.

What did the authors do?

A systematic review of literature related to research regarding communication between nurses and patients with complex communication needs (CCN) was carried out. Papers were published in English in peer-reviewed journals between 1990 and 2007 and addressed one or more of 4 identified areas: importance of communication, barriers to effective communication, supports needed for effective communication and recommendations for improving the effectiveness of communication between nurses and patients with CCN.

The papers were based on the perspectives of the nurse, patient or patients' families and carers.

What did they find?

Importance of nurse-patient communication

The possible impact of poor nurse-patient communication on quality of care was frequently highlighted. Some patients believed that communication with nurses was rarely successful, even when written information was given prior to hospital admission and many felt that even basic needs were unmet. Caregivers were afraid that the patient was at risk due to poor communication with nurses.

Barriers to effective nurse-patient communication

The majority of the papers indicated that interactions were limited to physical and medical needs, were minimal and often ineffective.The perception was that the difficulty was due to the nurses' lack of AAC knowledge and training or an unwillingness to provide assistive communication tools.

The increased time taken to communicate with people with CCN was another barrier. Other issues included; lack of access to AAC equipment, patients' inability to gain the nurses attention, patients' level of cognitive and/or language impairment, changes in nursing staff and pressure of family members in the care setting.

Supports for effective nurse-patient communication

Several supports identified as increasing communication effectiveness were related to the nurses; training received and experience of working with people with disabilities, willingness to take time and persist with interactions until the message was understood, willingness to ask family members or other professionals for assistance and willingness to share information during shift changes.

Factors related to the patient and environment were also identified and discussed.

Recommendations for improving communication

The main recommendations related to the need for training in CCN and AAC for nurses, including giving them information about augmented communication input for patients have difficulty in understanding spoken language and identifying the need for patients to be referred for further AAC assessment.


Things you may want to look into:

SPEACS-2: Intensive Care Unit 'Communication Rounds' with Speech Language Pathology 

Nurses' perceptions of communication training in the ICU

A systematic review of the effectiveness of nurse communication with patients with complex communication needs with a focus on the use of augmentative and alternative communication

Communication boards in critical care: patients' views

Added to site October 2014


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