Summary literature

Communicating to Non-Speaking Critically Ill Patients: Augmentative and Alternative Communication Technique as an Essential Strategy

Reference: SAGE Open Nursing Volume 7: 1–9

 The study reported that the nurses used variety of communication strategies while communicating to nonspeaking critically ill patients. However very few nurses used Augmentative and alternative communication strategies to communicate to non-speaking critically ill patients. The study recommends the importance of establishing Augmentative and Alternative Communication strategies in the hospitals.

Strategies for communicating with conscious mechanically ventilated critically ill patients


Critically ill patients admitted to the intensive care unit (ICU) frequently require ventilatory support. To provide this life-saving therapy, oral intubation or tracheostomy placements are needed. Consequently, verbal ability to communicate is lost. Furthermore, depending on the severity of the clinical condition and other comorbidities, patients commonly develop ICU-acquired weakness, which may preclude gestural communication and motor abilities. Under this circumstance, the patient’s inability to interact with health care providers and/or family members results in psychological alterations, as well as isolation and reduction of self esteem.

A variety of tools have been developed to improve patient-clinician communication. This article reviews patient complications due to lack of communication, available tools to enhance interactions, and current published evidence to support communication tools.

A systematic review on voiceless patients’ willingness to adopt high-technology augmentative and alternative communication in intensive care units

Intensive & Critical Care Nursing 63 (2021) 102948


Although the existing evidence is limited, voiceless patients regard high-tech AAC devices as a useful, reliable, and acceptable alternative communication choice in the ICU. Multicenter, large-sample, and high-quality studies are highly recommended in the future.

Outcome measurement tools for communication, voice and speech intelligibility in the ICU and their clinimetric properties: A systematic review

Journal of the Intensive Care Society


There is a relatively small number of studies which have established clinimetric properties for outcome measurement tools that evaluate communication, voice and/or speech intelligibility, and a fewer number which have done so in the mechanically ventilated ICU population.

Patients’ statements and experiences concerning receiving mechanical ventilation: a prospective video-recorded study

Nursing Inquiry 2012; 19(3): 247–258ù

The patients experienced almost constant difficulties in breathing and lost their voice. The most common types of communication techniques patients used were nodding or shaking the head. Their expressions were interpreted as stiffened facial expression, tense body position and feelings of sadness and sorrow. Nursing care for patients’ conscious during MVT is challenging as it creates new demands regarding the content of the care provided. In caring for patients undergoing MVT while conscious, establishing a caring relationship, making patients feel safe and helping them to communicate seem to be most important for alleviating discomfort and instilling hope.

The Effect of Using Communication Boards on Ease of Communication and Anxiety in Mechanically Ventilated Conscious Patients Admitted to Intensive Care Units

 J Nursing Midwifery Res 2018;23:358-62.

The results showed that the use of the communication board is possible in mechanically ventilated conscious patients and may contribute to ease of communication and decrease patients’ anxiety during mechanical ventilation.

A systematic review of the effectiveness of nurse communication with patients with complex communication needs with a focus on the use of augmentative and alternative communication

Journal of Clinical Nursing 17, 2102– 2115

Communication between nurses and patients is critical to providing and receiving quality care. Nurses and patients have reported concern and frustration when communication is not adequate. Using AAC strategies will help nurses and patients better communicate with each other when speech is not an option.