ACQ Vol 12 No 3 2010

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ACQ Volume 12, Number 3 2010 115
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O’Halloran, R., Worrall, L., Toffolo, D., Code, C., &
Hickson, L. (2004). Inpatient functional communication
interview. Oxon: Speechmark.
Parr, S., Wimborne, N., Hewitt, A., & Pound, C. (2008).
The communication access toolkit. London: Connect Press.
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and issues of infection control. Laminated 2mm perspex was
found to be firm enough to write on and light enough for a
weak or deconditioned patient to pick up and rest on their
torso or lap as needed. It can be thoroughly cleaned
between patients as per Austin Health infection control
policies. In collaboration with Scope (a disability service
provider) three modalities were chosen: 1) picture images
(Board-maker) with words beneath, 2) the alphabet for letter
spelling, and 3) blank space for writing. These alternative
options ensured that the device would be suitable for
patients with various levels of alertness and literacy. The
Wong-Baker FACES Pain Rating Scale (Wong, 2001) and
body diagrams were also included to assist patients to
communicate the severity and location of pain, as per
recommendations from the Austin Health pain team. A
marker was attached to the board for the patient to use if
appropriate, or for the family to write translations of the
pictures into other languages if the patient was not literate in
English. The board hangs over the bed rail so that the
patient can access it independently and initiate
communication as desired.
Kathryn McKinley graduated from La Trobe University in 1999
and worked at Austin Health while completing the training project.
Kathryn has received two scholarships, allowing her to visit Connect
and the Aphasia Institute in 2005 and Connect again in 2008.
Kathryn also received Royal Talbot Rehabilitation Centre’s Health
Professionals Scholarship in 2008 which funded the Communication
Access Training project. Kathryn is now the Speech Pathology
Manager at St Vincent’s Hospital in Melbourne.
Shauna Poole graduated from La Trobe University in 1992 and
has worked in aged-care rehabilitation at Austin Health since 1998.
Shauna has a special interest in making the hospital environment
communicatively accessible for all patients.
Melanie White graduated from La Trobe University in 1995.
She has worked at Austin Health for the past 10 years, specialising
in the areas of spinal injury, intensive care and tracheostomy
management. Melanie co-authored an article in 2003 on the
removal of the tracheostomy tube in the aspirating spinal cord
injured patient. She has been the recipient of the RACV Sir Edmund
Herring Memorial Study Grant, which she used to visit centres of
excellence in spinal injury centres in Denver and Atlanta, USA.
Correspondence to:
Kathryn McKinley
Speech Pathology Manager
St Vincent’s Hospital
41 Victoria Parade
Fitzroy VIC 3065
phone: +613 9288 3846
email:
Family member helping the patient to recall events leading up to his
medical admission – an unexpected use of the ICU communicator
Results
The board was trialled in a small group of patients and
feedback was sought from nursing staff in ICU before final
amendments were made. Feedback included some changes
to picture images (deletion of “I want the doctor” and
inclusion of “ I feel sick”, for example) and addition of
cleaning instructions. A limitation of the study was that
feedback could not be gained from patients due to their poor
recollection of their ICU stay. The ICU communication board
is now part of the standard equipment in every ICU bay. It
has also been purchased by a number of other facilities.
Conclusion
The importance of effective communication between
healthcare providers and the public they serve is well known
(O’Halloran, Hickson and Worrall, 2008). Hospital settings
can be perceived by patients and their families as
intimidating and confusing places. Experience of hospital can
be one of anxiety and stress, compounded by being unable
to communicate effectively. This article describes three
projects conducted independently by speech pathologists
working within a hospital. In each project communication
access was improved by addressing environmental factors
and thus reducing barriers to communication.