Date of Award

Spring 6-6-2024

Scholarly Projects

Projects: SPU Access Only

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

Faculty Chair

Katie Thralls Butte

Faculty Reader

Katie Thralls Butte

Executive Summary

Executive Summary

Title: Use of a Standardized Communication Tool to Improve Nurse Communication with Patients Undergoing Mechanical Ventilation

Background and Significance: This project will be focused on patients who acutely require mechanical ventilation. In the settings of this study, patients mostly require mechanical ventilation to support an acute illness or disease process, or they require support during and after cardiac surgery. Regardless of why a patient requires this support, the goal is typically to get the patient to the point where they can breathe on their own while decreasing the complications associated with this support. These complications include ventilator-associated pneumonia (VAP), sepsis, acute respiratory distress syndrome, atelectasis, pulmonary edema, deconditioning, cognitive impairment such as delirium, and more (Haribhai et al., 2022).

Purpose Statement: In response to the challenge of communicating with patients undergoing mechanical ventilation, the purpose of this mixed methods project was to determine the impact of use of a standardized communication tool with this critically ill population.

Methods: This study was a mixed methods survey design study conducted at two different hospitals in the same health care system on the cardiovascular intensive care unit (CVICU). This study required a pre-intervention survey, use of the intervention, and a post-intervention survey. Survey respondents were anonymous. Data was compiled after the survey closed by aligning pre- and post-intervention survey results using participant keywords to maintain the anonymity of participants. This data was then input into SPSS and a paired t-test was run.

Results and Outcomes: Fourteen nurses responded to the pre-intervention survey and ten of these nurses also completed the post-intervention survey. Only ten percent of respondents reported that their unit has a communication tool and they find it helpful. The rest of the respondents did not report that their unit had a communication board or that they had one and it was not helpful. A paired samples t-test was conducted to compare nursing belief in involvement of intubated patients in their care before and after utilizing a communicate board. The results indicate a significant difference in all five questions pre-and post-intervention

Sustainability: This project is sustainable in that the communication board is available for free to anyone who wants to use it. The laminated communication boards were left on the unit for continued use. Additionally, nurses were given the link to the communication board to use once the project was over. Managers or educators for the units may print out more copies if they are needed and the care team can continue to use them for intubated patients.

Implications: The results of this project show that use of a communication board increases nurse confidence in communicating with their intubated patients, leading the way to enhanced caregiving relationships, understanding between nurse and patient, improved communication, increased autonomy, and patients' ability to participate in their care. Future research should focus on patient experience with the communication boards and their incidence of sequelae after intubation after using this tool.

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