Characteristics of patient communication and prevalence of communication difficulty in the intensive care unit: An observational study.

PURPOSE

To summarise the patient communication status in an intensive care unit (ICU), including methods of communication used and the frequency, degree and nature of communication breakdown.

MATERIALS AND METHODS

A multidisciplinary daily ward audit was conducted on ten consecutive weekdays in a 30-bed general ICU of a tertiary Australian hospital. Data included patient demographics, patients' mode of communication and the level of difficulty in communicating. Descriptive statistics and means (standard deviation)/medians (interquartile range) were used to summarise the data.

RESULTS

Over the audit period, data were collected from 87 patients (median age 58 years, interquartile range 43 to 67; 60% males), equivalent to 232 occupied bed days. Patients from non-English-speaking backgrounds accounted for 14% of the cohort, with Mandarin the most common non-English language. Altered cognition occurred on 11% of bed days. Staff reported difficulty in communicating with patients on 35% of bed days, with an inability to communicate with patients in 49% of these cases. Alternate modes of communication were reported, with gesture the most common, but they were not used with all suitable patients.

CONCLUSIONS

About one-third of the caseload in the ICU experienced difficulty in communicating. While alternate communication methods were reported, they were not used with all patients. A multidisciplinary approach to enhance communication ability may be beneficial.