Effect of implementing structured communication messages on the clinical outcomes of unconscious patients

Abstract

Background: Patient communication is one of the most important factors associated with quality of care and patient safety, especially in Intensive Care Units (ICUs). However, relatively little is known about the different aspects of communication with unconscious patients, and the effect of communication and outcome measures. Aim: This study aimed to examine effects of implementing structured communication messages (SCMs) on the clinical outcomes of unconscious patients.

Methods: A quasi-experimental design was utilized. Sixty unconscious patients were selected from three ICUs of Emergency Hospital of Mansoura University and two ICUs at Main Hospital of Mansoura University. Patients were randomly allocated into two groups (intervention and control group) 30 patients in each. Four tools were used for data collection: physiological adverse events (PAE) assessment tool including (hyperthermia, hypothermia, tachycardia, bradycardia, hypertension, hypotension, hypovolemia, hypervolemia, desaturation, bradypnea, ventilatory distress, hyperglycemia or hypoglycemia), Full Outline of Un-Responsiveness (FOUR) scale, Behavioural Pain Scale (BPS), and Motor Activity Assessment Scale (MAAS).

Results: The implementation of SCMs was associated with a decreased incidence of PAE and a statistically significant positive effect on level of consciousness revealed by FOUR scale. Patients in the intervention group maintained in MAAS level (2-3) (calm, cooperative and responsive to touch). The BPS in intervention group significantly decreased following the application of SCMs than control group. Moreover, the mean duration of mechanical ventilation and length of stay in ICU were significantly shorter in the intervention group than in the control group.

Conclusions: The SCMs developed, has been shown to facilitate the communication with the unconscious patients therefore, it is recommended for use in a nurse’s daily routine of unconscious patients.