The overarching aim of this multicenter study is to develop a multimodule training intervention (COMMEC-ICU) for nurses working in ICUs, to increase nurses skills and knowledge and then improve communication for mechanically ventilated ICU patients. The intervention will be implemented at the included ICUs and evaluated both on nurses in the ICU and patients. Patients with delirium will also be included.
The specific objectives of the research proposal are to: 1. Investigate ICU patients' perceptions of communication difficulties during mechanical ventilation, and evaluate the relationship between communication difficulties and symptom burden. 2. Describe ICU nurses' communication skills, communication techniques commonly used, and satisfaction with communication with patients. The results from objectives 1 and 2 are of relevance as such, but will also be used as a basis to develop the COMMEC-ICU and as a pre-intervention measure prior to implementation of the new program. 3. Further develop and implement COMMEC-ICU in the selected ICUs. 4. Evaluate the effect of COMMEC-ICU on a) ICU nurses after receiving the training program b) former ICU patients that have been treated in the ICUs with were the intervention have been implemented.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
500
A multi module intervention where the nurses will learn about communication with mechanically ventilated patients will be developed. The investigators hypothesize that this intervention will: 1. make it easier for mechanically ventilated ICU patients to communicate their needs and symptoms during mechanical ventilation and to improve their symptom burden. 2. improve ICU nurses' skills in communicating with ICU patients who are unable to speak. This will potentially contribute to better communication with critically ill patients, including those being delirious. 3. improve ICU nurses´ satisfaction with their communication.
Oslo University Hospital
Oslo, Norway
Ease of Communication Scale- patients
10-item instrument using a 5-point Likert scale to assess communication difficulty (0 "not hard at all"; 1 "a little hard"; 2 "somewhat hard", 3 "quite hard", and 4 "extremely hard").
Time frame: 6-8 months before and 4 weeks after the intervention were nurses go through a training program
Nurses communication skills and satisfaction
The scale is developed based on previous studies about communication with ICU patients. It consists of items covering self-perceived competency and satisfaction of communication skills. The scale consists of 16 questions about their satisfaction with communication on a 5 point Likert scale from "never" to "always", and 7 questions about their use of communication aids on a 5 point Likert scale from "never" to "always". The last seven items also have one option to tick "not available".
Time frame: 6-8 months before and 3 months after the intervention (communication training program)
10 Symptom checklist- patients
The scale consists of 10 items, but we will only use 5 symptoms in the present study. Patients can rate whether the symptom (pain, tiredness shortness of breath, anxiety, thirst) is present (tick if yes). If present they are asled about intensity (0=not at all and 10= Very serious) and level of distress (1=not very distressing to 10=very distressing).
Time frame: Symptom assessement will be conducted at ICU discharge, 3-6 months before and one to two months after the intervention is given to the nurses.after the intervention.
Symptom communication nurses
10 questions about the communication symptoms, on a 10 point scale from extremely difficult to very easy
Time frame: 6-8 months before the intervention and 3 months after the intervention (communication training program).
Norwegian version of Self-efficacy questionnaire SE-12- nurses
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The scale consists of 16 questions about self perceived competency of communication skills. The scale will be answered on a 10 point Likert scale from "not sure at all" to "very sure". Some questions about the effect of the communication and perceived use of the communication course will be added to the measurement 3 months after the intervention.
Time frame: 6-8 months before and 3 months after the intervention (communication training program)