title: Exploring Communication Challenges Between Nurses and Mechanically Ventilated Patients in the Intensive Care Unit: A Structured Review.
abstract: BACKGROUND
  Mechanical ventilation is a necessary procedure for patients with a range of illnesses and conditions. Mechanical ventilation affects voice production, leaving patients unable to communicate their needs with nurses and family. The communication difficulty causes distress, frustration, and anger if not attended to.
  
  
  OBJECTIVE
  This structured review sought to identify communication challenges which exist between nurses and mechanically ventilated patients in intensive care units (ICU) and hence explore possible solutions to improve these communication challenges.
  
  
  METHODS
  A electronic search of MEDLINE, CINAHL, and PsycINFO was conducted to identify relevant literature on nurse-patient communication challenges in the ICU published between January 2005 and December 2014. Studies meeting the inclusion criteria were retrieved in full, reviewed, and study quality assessed.
  
  
  RESULTS
  Six studies were identified for inclusion in the review. Analysis identified five core influences on communication in the ICU: patient's consciousness level, nature of nurse-patient interactions, communication methods, staff skills and perceptions, and the intensive care physical environment.
  
  
  CONCLUSIONS
  An evidence-based and multifactorial communication intervention encompassing staff skills development and training, development of relevant patient materials or devices and collaborations with relevant health professionals like speech and language therapists has the potential to improve nurse-patient communication in the ICU and hence improve patient outcomes.
authors: Clinical Nurse Specialist, Department of Health Studies, University of South Africa, Pretoria, South Africa.
authors: Kefalotse
authors: K
authors: Dithole
authors: Research Fellow, Department of Health Studies, University of South Africa, Pretoria, South Africa.
authors: Sambulelwe
authors: S
authors: Sibanda
authors: Professor of Nursing Studies, Department of Health Studies, University of South Africa, Pretoria, South Africa.
authors: Mary M
authors: MM
authors: Moleki
authors: Professor of Nursing Studies, Department of Health Studies, University of South Africa, Pretoria, South Africa.
authors: Gloria
authors: G
authors: Thupayagale-Tshweneagae
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration; D009723:Nurse-Patient Relations; D012121:Respiration, Artificial / Q000009:adverse effects*
keywords: communication challenges; intensive care unit; mechanically ventilated patient; nurse-patient communication; structured review