Co-Investigator: Derek C. Angus, MD, MPH
The main goal of this study is to examine the value of a multi-faceted, nurse-generated/nurse-led innovation to improve ICU nurse communication skills in improving the care and outcome of critically ill patients rendered ‘voiceless’ by mechanical ventilation. The study will focus on SPEACS, a previously tested program of nurse training, communication materials and specialist consultations, which showed improvements in the process of nurse-patient communication in the ICU. Specifically, the study aims are to: 1) Extend the SPEACS intervention to a unit-based dissemination model (SPEACS-2); 2) Test the impact of the SPEACS-2 intervention on patient care outcomes: nursing care quality indicators (coma-free days, physical restraint use, pain symptom management, patient/ family satisfaction with communication), and utilization (ICU days, ventilator-free days, hospital days), discharge disposition, and cost. 3) Test the impact of the SPEACS-2 communication training program on nurse outcomes (communication knowledge, burnout). The SPEACS-2 project relates to the INQRI program goals by explicitly quantifying the relationship between improved processes of nurse-patient communication and patient care outcomes in the ICU, making visible the contribution to care quality provided by nurse communication interactions with ICU patients.