Objectives: This study aimed to examine changes in the practice of nurses who received an intervention designed to increase their awareness of endotracheally intubated, lightly sedated mechanically ventilated patients' intent to communicate.
Research methodology: Action research was applied. Specifically, three interventions promoting awareness of patients' intent to communicate were administered and pre- and post-intervention, observations of patient-nurse interactions, unstructured interviews with nurses and a patients' satisfaction survey were conducted. The pre- and post-intervention patient-nurse interactions and patients' survey results were then compared and a content analysis of the interviews and field notes was performed.
Setting: The intensive care unit of a university hospital.
Main outcome measure: Nurses' awareness of lightly sedated mechanically ventilated patients' intent to communicate.
Findings: After the intervention, the incidence-rate ratios for nurses noticing of patients' intent to communicate were 1.53; there was no change in the frequency of patients' intent to communicate. Further, nurses became more aware of and reflected on their own practices, showed increased interest in co-workers' practices and considered their actions from patients' perspectives. Patients' satisfaction with nurses' respect for their wishes and dignity also increased.
Conclusions: Action research can induce a change in intensive-care-unit-based nursing practice towards patient-centred care.
Keywords: Action research; Communication; Critical care nursing; Intensive care unit; Light sedation; Mechanical ventilation; Patient dignity.
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