Doctoral student explores methods to improve ICU team communication

Emma Blackmon, a doctoral candidate at the Betty Irene Moore School of Nursing at UC Davis, uses simulation to examine how communication in the ICU can lead to safer patient care.

Communication and teamwork are vital to the delivery of high quality and safe patient care, particularly in the dynamic, complex and high-risk environment of the intensive care unit (ICU). Yet, studies examining interprofessional ICU interactions around high-risk, low-frequency events – such as the pronation of a critically ill patient – are few and far between.

“I feel like the ideas and concepts of communication and teamwork are the ether in which we all work. But it’s not easily seen or quantified,” says Emma Blackmon, an ICU nurse of 15 years and a doctoral candidate at the Betty Irene Moore School of Nursing at UC Davis.

A new exercise determines perceptions

Health team practices pronation in a simulation suite
Six health providers, including nurses, respiratory therapists and lift-team members, practice moving a ventilated patient to a face-down position in a high-fidelity simulation suite.

Blackmon says most of the studies to improve team communications revolve around life-and-death scenarios. For her dissertation research, she developed a high-fidelity simulation scenario of the moving of a critically ill adult patient in an ICU by an interprofessional team. Prone positioning — moving a patient to a face-down position — is used to improve oxygenation in patients who suffer from acute respiratory distress syndrome. The team consisted of up to six providers, including registered nurses, respiratory therapists, lift-team members and physicians. She wanted to know if the participants perceptions would change after the exercise.

“A lot of the errors —such as such as inadequate patient handoffs and treatment delays —that happen in a hospital can be traced to a breakdown or lack in communication,” Blackmon explains. “But capturing that is difficult. You’re trying to target the human element. The way we communicate involves so many things. It’s personal, professional and experiential.”

Change puts patients first

The Joint Commission on Accreditation of Healthcare Organizations describes communication error as the cause of 60% to 70% of preventable hospital deaths. Continued opportunities to participate in activities to understand and improve communicative behaviors, role identification and teamwork are necessary to navigate and care for critically ill patients in the ICU.

Blackmon says she’s fortunate to be part of a team at UC Davis Health where interprofessional teams are recognized for their collaboration and support. She hopes to further her research so other teams —in ICU and other hospital units nationwide —can benefit from her findings.

“If we don’t work on communication, there’s always going to be a breakdown,” Blackmon says. “I don’t think we can deliver patient-centered care unless we reflect on ourselves.”

Blackmon, along with other School of Nursing graduate students, present their research at the annual Academic Symposium June 7at the UC Davis Sacramento campus.