Högskolan i Skövde

Aim: To conduct a review summarizing evidence concerning communication with mechanically ventilated patients in the intensive care unit (ICU).

Background: ICU patients undergoing mechanical ventilation are unable to communicate verbally, causing many negative emotions. Due to changes in sedation practice, a growing number of patients are conscious and experience communication difficulties.

Design: The umbrella review method guided by the Joanna Briggs Institute was applied.

Data Sources: A systematic search was done in the Cochrane Library, the Joanna Briggs Institute database, Cinahl, Pubmed, PsycINFO and Scopus between January-April 2019. Search terms were ‘nurse-patient communication’, ‘mechanical ventilation’, ‘intensive care’, and ‘reviews as publication type’. Literature from 2009–2019 was included.

Review Methods: Following recommendations by the Joanna Briggs Institute, a quality appraisal, data extraction, and synthesis were done.

Results: Seven research syntheses were included. There were two main themes and six subthemes: (1) Characterization of the nurse–patient communication: (a) Patients' communication; (b) Nurses' communication; (2) Nursing interventions that facilitate communication: (a) Communication assessment and documentation; (b) Communication methods and approaches; (c) Education and training of nurses; and (d) Augmentative and alternative communication.

Conclusion: Nurse–patient communication was characterized by an unequal power relationship with a common experience – frustration. Four key interventions were identified and an integration of these may be key to designing and implementing future ICU communication packages.

Impact: Nurse–patient communication is characterized by an unequal power relationship with one joint experience – frustration. Four key interventions should be integrated when designing and implementing communication packages in the ICU. Findings are transferable to ICU practices where patients are conscious and experience communication difficulties.