Effectiveness of communication strategies for patients who are non-vocal due to artificial airways

Bass EM, Maillie S, Mitchell MD, Jablonski J, Dubin R, Mull NK
Record ID 32018005204
Authors' objectives: Identified and summarized evidence on communication strategies for patients who are non-vocal due to artificial airways such as endotracheal tubes or tracheostomies.
Authors' results and conclusions: - A variety of communication aids are available to assist patients who are unable to communicate with their caregivers. There is little evidence to demonstrate that one type is better than another. Overall, much of the evidence found was observational and of low quality. Available RCTs were deemed to have a high risk of bias. Heterogeneity of interventions and outcomes in the reported studies further complicated analysis. - Guidelines related to the topic offered few recommendations other than widespread caregiver education on the use of interventions that directly manipulate the airway. For less invasive non-vocal interventions, calm attention and awareness of distractions are advised regardless of specific type of aid. Caregivers should have a sound understanding of how to use airway aids and to be patient and thoughtful using any sort of communications aid. - The Joint Commission recommends that communication kits be assembled with a variety of AAC materials available to suit the needs of the patient and caregiver. How to sustainably maintain such kits and educate caregivers on their use is not discussed. A review of the UPHS entity intranets found wide variation in AAC resources and their locations. - Patient satisfaction was statistically significantly improved with all interventions that measured that outcome. - Nurse comfort in communicating with non-vocal patients appeared to improve with education and preparing patients for non-vocal episodes was associated with a possible decrease in duration of mechanical ventilation, but no significant change in patient care quality was found. - Suggestions for future studies that would be helpful for guiding practice include direct comparisons of standardized interventions along with comparable outcomes or implementation research designs for creating sustainable practices in non-vocal communication care
Project Status: Ongoing
Anticipated Publish Date: 2023
Requestor: nursing
English language abstract: An English language summary is available
Publication Type: Rapid Review
Country: United States
MeSH Terms
  • Communication Barriers
  • Communication Aids for Disabled
  • Communication Methods, Total
  • Tracheostomy
  • Communication
  • Respiration, Artificial
  • Critical Care
  • mechanical ventilation
  • tracheostomy
Organisation Name: Penn Medicine Center for Evidence-based Practice
Contact Address: Penn Medicine Center for Evidence-based Practice, University of Pennsylvania Health System, 3600 Civic Center Blvd, 3rd Floor West, Philadelphia PA 19104
Contact Name: Nikhil Mull
Contact Email: cep@pennmedicine.upenn.edu
Copyright: <p>Center for Evidence-based Practice (CEP)</p>
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.