Mary Beth Happ1, Susan M Sereika2, Martin P Houze2, Jennifer B Seaman3, Judith A Tate4, Marci L Nilsen5, Jennifer van Panhuis6, Andrea Scuilli7, Brooke M Baumann, Brooke Paull7, Elisabeth George7, Derek C Angus8, Amber E Barnato9. 1. The Ohio State University College of Nursing, Columbus, OH, USA; The CRISMA Laboratory (Clinical Research, Investigation, and Systems Modeling of Acute Illness), Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA. Electronic address: aeb2@pitt.edu. 2. Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA. 3. The CRISMA Laboratory (Clinical Research, Investigation, and Systems Modeling of Acute Illness), Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA. 4. The Ohio State University College of Nursing, Columbus, OH, USA. 5. Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA. 6. Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 7. University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 8. The CRISMA Laboratory (Clinical Research, Investigation, and Systems Modeling of Acute Illness), Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 9. Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Department of Health Policy and Management, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA.
Abstract
OBJECTIVES:Implement and test unit-wide patient-nurse assisted communication strategies (SPEACS). BACKGROUND: SPEACS improved nurse-patient communication outcomes; effects on patient care quality and resource use are unknown. METHODS: Prospective, randomized stepped-wedge pragmatic trial of 1440 adults ventilated ≥2 days and awake for at least one shift in 6 ICUs at 2 teaching hospitals 2009-2011 with blinded retrospective medical record abstraction. MAIN RESULTS: 323/383 (84%) nurses completed training; their communication knowledge (p < .001) and satisfaction and comfort (p < .001) increased. ICU days with physical restraint use (p = .44), heavy sedation (p = .73), pain score documentation (p = .97), presence of ICU-acquired pressure ulcers (p = .78), coma-free days (p = .76), ventilator-free days (p = .83), ICU length of stay (p = .77), hospital length of stay (p = .22), and median costs (p = .07) did not change. CONCLUSIONS: SPEACS improved ICU nurses' knowledge, satisfaction and comfort in communicating with nonvocal MV patients but did not impact patient care quality or resource use.
RCT Entities:
OBJECTIVES: Implement and test unit-wide patient-nurse assisted communication strategies (SPEACS). BACKGROUND: SPEACS improved nurse-patient communication outcomes; effects on patient care quality and resource use are unknown. METHODS: Prospective, randomized stepped-wedge pragmatic trial of 1440 adults ventilated ≥2 days and awake for at least one shift in 6 ICUs at 2 teaching hospitals 2009-2011 with blinded retrospective medical record abstraction. MAIN RESULTS: 323/383 (84%) nurses completed training; their communication knowledge (p < .001) and satisfaction and comfort (p < .001) increased. ICU days with physical restraint use (p = .44), heavy sedation (p = .73), pain score documentation (p = .97), presence of ICU-acquired pressure ulcers (p = .78), coma-free days (p = .76), ventilator-free days (p = .83), ICU length of stay (p = .77), hospital length of stay (p = .22), and median costs (p = .07) did not change. CONCLUSIONS: SPEACS improved ICU nurses' knowledge, satisfaction and comfort in communicating with nonvocal MV patients but did not impact patient care quality or resource use.
Authors: Jennifer B Seaman; Anna C Evans; Andrea M Sciulli; Amber E Barnato; Susan M Sereika; Mary Beth Happ Journal: West J Nurs Res Date: 2016-09-07 Impact factor: 1.967
Authors: Louise Rose; Anna-Liisa Sutt; Andre Carlos Amaral; Dean A Fergusson; Orla M Smith; Craig M Dale Journal: Cochrane Database Syst Rev Date: 2021-10-12
Authors: Maureen George; Carme Hernandez; Sheree Smith; Georgia Narsavage; Mary C Kapella; Margaretann Carno; Jill Guttormson; Rebecca T Disler; Diana E Hart; Linda L Chlan; Mary Beth Happ; Zijing Chen; Breanna Hetland; Ana F Hutchinson; Helga Jonsdottir; Nancy S Redeker; Hildy Schell-Chaple; Monica Fletcher; Janelle Yorke Journal: Ann Am Thorac Soc Date: 2020-01