Kuruppu Nipuna R, Chaboyer Wendy, Tobiano Georgia, Abayadeera Anuja, Ranse Kristen
School of Nursing and Midwifery, Griffith University, Queensland, Australia; Department of Nursing, Faculty of Health Sciences, The Open University of Sri Lanka, Nawala, Nugegoda, Sri Lanka.
School of Nursing and Midwifery, Griffith University, Queensland, Australia; NHMRC CRE in Wiser Wound Care, Griffith University, Queensland, Australia.
Intensive Crit Care Nurs. 2025 Apr;87:103891. doi: 10.1016/j.iccn.2024.103891. Epub 2024 Nov 20.
To evaluate the feasibility of implementing a communication board in intensive care units in terms of participant recruitment and retention, intervention fidelity, and ability to collect patient outcome data.
A prospective, two-arm, unblinded, pilot randomised controlled trial.
Adult, conscious, mechanically ventilated intensive care patients were recruited between August and November 2023. All participants received routine communication practices; the intervention group also received the communication board. Prior to the study, all nurses were trained on using the communication board. Patient or proxy consent was obtained. Data were collected from patients, nurses, patients' medical records, and screening, tracking, intervention fidelity, and contamination logs.
The primary outcome data was feasibility of participant recruitment, retention, and intervention fidelity, which was recorded daily until seven days of follow-up or pre-defined trial endpoints. Secondary patient outcomes (anxiety, satisfaction, ease of communication) were assessed at recruitment and approximately 24 h after recruitment or soon after extubation, whichever occurred first.
Two intensive care units in one Sri Lankan tertiary care hospital.
Of the 123 patients, 60 (75.0%) were recruited and randomised (30 control; 30 intervention). All intervention group patients received the communication board (100% intervention fidelity), and 58 (96.7%) completed the follow-up. On recruitment, 12.5% of secondary patient outcome data was missing, and 9.9% on follow-up, predominantly associated with the 10-item ease of communication scale.
Conducting a larger, definitive communication board trial is feasible but collecting secondary patient outcome data, especially ease of communication was challenging. Study procedures need to be refined prior to a larger trial.
The use of communication boards in intensive care units may improve patient-centred care for ventilated patients but requires further, high quality effectiveness trials.
从参与者招募与留存、干预保真度以及收集患者结局数据的能力方面，评估在重症监护病房实施沟通板的可行性。
一项前瞻性、双臂、非盲、试点随机对照试验。
2023年8月至11月招募成年、意识清醒、接受机械通气的重症监护患者。所有参与者均接受常规沟通措施；干预组还接受沟通板。研究前，所有护士均接受了使用沟通板的培训。获得了患者或代理人的同意。从患者、护士、患者病历以及筛查、跟踪、干预保真度和污染记录中收集数据。
主要结局数据为参与者招募、留存和干预保真度的可行性，每天记录直至随访7天或预定义的试验终点。次要患者结局（焦虑、满意度、沟通便利性）在招募时以及招募后约24小时或拔管后不久（以先发生者为准）进行评估。
斯里兰卡一家三级护理医院的两个重症监护病房。
123例患者中，60例（75.0%）被招募并随机分组（30例对照组；30例干预组）。所有干预组患者均接受了沟通板（干预保真度100%），58例（96.7%）完成了随访。招募时，次要患者结局数据缺失12.5%，随访时缺失9.9%，主要与10项沟通便利性量表相关。
开展更大规模、确定性的沟通板试验是可行的，但收集次要患者结局数据，尤其是沟通便利性数据具有挑战性。在开展更大规模试验之前，需要完善研究程序。
在重症监护病房使用沟通板可能会改善以患者为中心的通气患者护理，但需要进一步开展高质量的有效性试验。
