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8 Nurses perspectives toward patient communication using a low technology communication board in an Intensive Care Unit. Keywords: ICU patients, vulnerable communicators, ICU nurses, communication board, low technology AAC. Aim: This paper will aim to determine nurses perspectives toward patient communication, using a low technology communication board in the ICU prior training ICU nurses how to implement the low technology communication board, after a two week implementation period and two weeks after a withdrawal period. In addition, exploring the characteristics of nurses, patients and the environment, which influence communication in the ICU. Extended abstract: Patients who are admitted into an intensive care unit (ICU) have extremely serious medical conditions, often influencing independent breathing, which frequently require the insertion of an oral endotracheal tube (ETT) or tracheostomy (Beukelman, Garrett & Yorkson, 2007). Consequently, patients in the ICU who are intubated may experience communication difficulties, including non-verbal communication difficulties (Beukelman et al., 2007, Braun-Janzen, Sarchuk & Murray, 2009; Happ et al., 2014; Happ, Roesch & Garrett, 2003; Patak et al., 2006). Due to the communication difficulties, communication between the patient and the nurse may be ineffective in the ICU and may result in communication breakdowns, the most frequent cause of adverse events in the hospital setting (Braun- Janzen et al., 2009; Costello, 2000; Patak et al., 2006), involving an increased risk of medical errors (Patak et al., 2009). Not only is the need for effective communication between nurses and patients imperative to alleviate adverse events (Fincke, Light & Kitko, 2008), patients have a right to communicate effectively and it also forms part of a nurse s role. Communication is usually initiated by nurses, and is restricted to task and procedure-orientation messages (Radtke et al., 2012), yes/no questions or directing the conversation to predictable answers (Patak et al., 2009). Augmentative and alternative communication (AAC) strategies can facilitate communication for patients who are vulnerable communicators in the ICU, but nurses receive inadequate support and training to implement AAC communication strategies (Beukelman & Mirenda, 2005). Supporting, training and providing access to AAC communication strategies are the role of the speech- language pathologist. Studies showed that patients were significantly more satisfied communicating with an aided low technology communication board during mechanical ventilation, compared to patients who did not use a communication board at all (Happ et al., 2014). Thus, low technology AAC may alleviate communication breakdowns between patients and nurses in the ICU. AAC communication strategies and implementation depend on nurses training, and access to a low technology communication board. Aim: The main aim of this study was to compare the perspectives of nurses toward communication with patients in ICU using a low technology AAC device, namely the translated Vidatak EZ communication board, before and after training in the implementation of the device. In order to attend to this aim, five sub-aims were formulated, namely to determine nurses perspectives

9 regarding patient communication in ICU before training in the implementation of the translated Vidatak EZ communication board, to translate the Vidatak EZ communication board from English to Setswana using a rigorous blind-back translation procedure, to train nurses how to use the translated Vidatak EZ communication board with the patients in ICU, to determine nurses perspectives with Post-test 1 regarding patient communication in the ICU after the translated Vidatak EZ communication board was implemented for a two week period, and lastly to determine nurses perspectives regarding patient communication in the ICU with Post-test 2, two weeks post the completion of Post-test 1. Method: A four phase, quasi-experimental Pre-test, Post-test group design with withdrawal including a control group was used. The Pre-test, Post-test design is effective to detect change, following the implementation of training, when the same measurement is used for both tests and by including a control group, inferences regarding training on how to implement the translated Vidatak EZ communication board could be made, Results Results were statistically analyzed and will be discussed in detail in the presentation. Results will be discussed and explained by comparing Pre-test, Post-test 1 and Post-test 2 regarding the characteristics of nurses, patients, and the environment, AAC communication strategies, and the implementation of the AAC low technology communication board. Additionally, recommendations for future research will be addressed. Conclusion Although a communication board can be implemented and utilized in the ICU, the low technology AAC board needs adaptations. Moreover, improved training strategies on how to implement the low technology AAC board is necessary to ensure long-term implementation success. Declaration of Interest statement 1. The authors disclose they have no financial or other interest in objects or entities mentioned in this paper. References: Beukelman, D. R., Garrett, K. L., & Yorkston, K. M. (2007). Augmentative Communication Strategies. For adults with Acute or Chronic Medical Conditions. Baltimore, MA: Paul H. Brookes. Beukelman, D. R., & Mirenda, P. (2005). Augmentative and alternative communication. Management of severe communication disorders in children and adults Baltimore, MA: Paul H. Brookes. Braun-Janzen, C., Sarchuk, L., & Murray, R. P. (2009). Roles of speechlanguage pathologists and nurses in providing communication intervention for nonspeaking adults in acute care: A regional pilot study. Canadian Journal of Speech-Language Pathology and Audiology, 33(1), 5-17.

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