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What is the challenge your project is going to address and how does it connect to your chosen theme?

Over 200,000 patients are admitted to intensive care and high dependency units (ICU/HDU) in the United Kingdom each year. Patients may be fully aware but temporarily unable to speak due to intubation or tracheotomy. This is one of the most frequently reported distressing symptoms for these patients, resulting in frustration, anxiety, and sleeplessness (Rotondi et al 2002).

It is known that communication aids and strategies can be beneficial on ICU/HDU, but nurses are not trained in communication, and SLTs do not normally provide support to patients temporarily unable to communicate. Building improvement capabilities across boundaries between nurses, SLTs and medics may help to address this.

A service evaluation of a training and communication app intervention suggested that providing training for nurses and links with SLTs may facilitate better communication between patients and nurses, contributing to better overall patient outcomes.

What does your project aim to achieve?

Aims

To improve communication between nurses and patients on intensive care and high dependency wards (ICU/HDU) who are temporarily unable to speak due to reasons including intubation and tracheotomy.

To add to the understanding of the barriers and facilitators of improved communication on ICU and HDU wards in the NHS.

To evaluate and improve the training and resources we have previously developed.

To understand how to build improvement capability across boundaries between nurses, SLTs and medics in order to embed and sustain improved communication.

Objectives:

To deliver a training intervention for nurses, which has been co-designed by people who have previously been intubated on ICU/HDU.

To evaluate the effectiveness of the intervention.

To report and disseminate findings with the aim of improving communication in the South Yorkshire and Bassetlaw STP region and to look at how the findings could be applied nationally.

To publish resources as an open resource for others to use.

How will the project be delivered?

Building on a previous service evaluation at Barnsley Hospital and previous academic research with Imperial College London, we will provide an existing intervention to ICU/HDU wards across South Yorkshire and Bassetlaw STP footprint area.

Intervention

We will undertake local observations of ICU/HDU communication to tailor the training package and review at an organisational level what is required to embed and sustain improved communication.

An SLT will deliver the training and provide communication resources to staff identified as key patient communication partners.

Evaluation

We will seek appropriate ethical approval to evaluate the intervention through ward observations, qualitative interviews with staff, and qualitative interviews with patients who have recovered after being on the ward subsequent to the training being in place.

This builds on the evaluation method used in prior qualitative research (Mobasheri et al 2016), and the service evaluation.

What and how is your project going to share learning throughout?

We would use the Q community structure to deliver learning outcomes from our project, both during and at the end of the study. We would welcome suggestions for routes to dissemination by Q community members, including presenting and publishing in both clinical and academic forums.

Having previously carried out a service evaluation and previous academic research into this area we are aware of barriers and facilitators to uptake of communication strategies on ICU/HDU. This project would provide learning potential ways of overcoming these barriers which would be shared within Yorkshire and Bassetlew STP and nationally.

Reporting in academic and clinical publications will be used as a route to dissemination to SLTs and nurse practitioners.

Existing links with national organisations such as the Royal Colleges of Nursing and Speech and Language Therapists would be used to promote and disseminate learning nationally.

How you can contribute

  • We would welcome all input from Q community members, and would particular looks for members to:
  • Share other best practise in order to contribute to the review of the open access resource.
  • Identify wards which may be able to adopt this practise.
  • Identify routes for dissemination and influencing national policy.

Plan timeline

1 Jan 2020 Develop ethics application and acheive permission
1 Mar 2020 Appoint band 6 SLT researcher
1 Mar 2020 Identify and prepare sites
1 May 2020 Carry out intervention
1 Sep 2020 Evaluate intervention and report findings

Comments

  1. What a great idea! Would love to see this in practice. We all know how frightening and frustrating it can be as a patient and anything that helps this could have a huge impact. Thank you for proposing it. Do you need any help with it?

    best wishes

    Anna

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