• Mary Beth Happ, Susan M Sereika, Martin P Houze, Jennifer B Seaman, Judith A Tate, Marci L Nilsen, Jennifer van Panhuis, Andrea Scuilli, Brooke M Baumann, Brooke Paull, Elisabeth George, Derek C Angus, and Amber E Barnato.
• The Ohio State University College of Nursing, Columbus, OH, USA; The CRISMA Laboratory (Clinical Research, Investigation, and Systems Modeling of Acute Illness), Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA. Electronic address: aeb2@pitt.edu.
• Heart Lung. 2015 Sep 1; 44 (5): 408-415.e2.

ObjectivesImplement and test unit-wide patient-nurse assisted communication strategies (SPEACS).BackgroundSPEACS improved nurse-patient communication outcomes; effects on patient care quality and resource use are unknown.MethodsProspective, randomized stepped-wedge pragmatic trial of 1440 adults ventilated ≥2 days and awake for at least one shift in 6 ICUs at 2 teaching hospitals 2009-2011 with blinded retrospective medical record abstraction.Main Results323/383 (84%) nurses completed training; their communication knowledge (p < .001) and satisfaction and comfort (p < .001) increased. ICU days with physical restraint use (p = .44), heavy sedation (p = .73), pain score documentation (p = .97), presence of ICU-acquired pressure ulcers (p = .78), coma-free days (p = .76), ventilator-free days (p = .83), ICU length of stay (p = .77), hospital length of stay (p = .22), and median costs (p = .07) did not change.ConclusionsSPEACS improved ICU nurses' knowledge, satisfaction and comfort in communicating with nonvocal MV patients but did not impact patient care quality or resource use.Copyright © 2015 Elsevier Inc. All rights reserved.

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