Effectiveness of an individualized communication protocol on clinical outcomes of comatose patients in selected intensive care unit of tertiary care hospital

Abstract

Background: Communication with patients is one of the important aspects of nursing care in critical care settings. Nurses play an important role in communicating with seriously ill patients Objectives: To assess the effectiveness of Individualized Communication Protocol (ICP) on clinical outcomes of comatose patients in terms of physiological adverse events, consciousness, agitation & sedation and pain level. Methods: A “quasi-experimental” was adopted to conduct the study on 113 comatose patients admitted in ICU. Initially, 58 patients were enrolled in the control group and their clinical outcomes viz. physiological adverse events, consciousness, agitation & sedation and pain level were collected twice daily till 14 days or transfer out of patients from ICU/Death/LAMA, whichever was earlier. Training was imparted to ICU nurses regarding Individualized Communication Protocol (ICP) consisting of environmental preparation, verbal and nonverbal communication with patients in coma by nurses and family members. After training of staff nurses, patients were enrolled in experimental group (n=55) and similar outcome variables were collected for experimental group. xxxi Results: Study results revealed that patients in experimental and control group were homogenious in term of their socio-demographic and clinical variables. The study findings showed that nurses’ knowledge and practice regarding individualized communication increased in post test. The conscious level improved in experimental group on 4th day as compared to control group (p<0.0001). It was observed that patients in experimental group required less sedation as compared to control group. Pain score also decreased in experimental group compared to control group. Conclusions: The ICP developed by the researcher facilitated communication with comatose patients by staff nurses in ICU. Therefore, it is recommended that ICP should be incorporated as a routine care.