Nursing evidence-based interprofissional practice guidelines for impaired verbal communication in ICU – Systematic Literature Review

Nathalia Conceição Nunes Rodrigues da Silva, Isabel Cruz


Interaction with people in impaired communication conditions requires special reflection and sensitivity to understand what the patient wants. However, there is the problem of the lack of information on the interprofessional practice based on scientific evidence and its guidelines for the diagnosis and prescription of nursing for the highly complex patient with impaired verbal communication under intensive care. Objective to review the evidence-based interprofessional guidelines that will assist the intensivist nurse in the identification and treatment of nursing care related to impaired verbal communication in the context of the interprofessional team. Descriptive method, carried out through a systematized bibliographic review based on secondary works, published in the period from 2011 to 2017. Pubmed, Cinahl, Bdenf and Lilacs databases were used in the Portuguese and English languages in nursing journals, with the strategy of PICO research being elected respectively (P) Critical Care AND Nursing AND (I) Acquired communication disorder OR communication barrier AND Nonverbal Communication AND (O) Communication. Results selection of 10 articles (from 31 retrieved) that collaborated with the resolution of the research problem and classified according to its content and reliability. Conclusion nursing professionals need to appropriate nonverbal methods for communicating with patients, including knowledge of Sign Language as well as the field of alternative communications with imaging with the intention of promoting individualized care with excellence.


Nonverbal Communication; critical care; nursing

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Sotierj. Terapia intensiva: abordagens atuais do enfermeiro. 1st ed. Rio de Janeiro: Atheneu; 2017.

Potter, PA. Fundamentos de Enfermagem. 7th ed. Rio de Janeiro: Elsevier; 2009.

Herdman TH, Kamitsuru S. Diagnóstico de enfermagem de NANDA-I: definições e classificação 2018-2020. 11th ed. Porto Alegre: Artmed; 2017.

Bulechek GM, Butcher K, Dochterman JM, Wagner CM.. Classificação das intervenções em enfermagem (NIC). 6th ed. Rio de Janeiro: Elsevier; 2016.

Johnson M. Ligações NANDA- NOC- NIC: condições clínicas: suporte ao raciocínio e assistência de qualidade. 3rd ed. Rio de Janeiro: Elsevier; 2012.

Pendergrass KM, Nemeth L, Newman SD, Jenkins CM, Jones EG. Nurse practitioner perceptions pf barriers and facilitators in providing health care of deaf American Sign Language users: a qualitative socio-ecological approach. Journal of the American Association of Nurse Practitioner. 2017 Jun: p. 316-323. Available from:

Handberg C, Voss AK. Implementing augmentative and alternative communication in critical care settings: perspectives of health care professionals. Journal of Clinical Nursing. 2018 jan: p. 102-114. Available from:

Kuenburg A, Fellinger P, Fellinger J. Health care acess among deaf people. Journal of Deaf Studies and Deaf Education. 2016 Jan: p. 1-10. Available from:

Rose L, Haslam L, Dale C, Knechtel L, Fraser M, Pinto R, et al. Survey of assessment and management of pain of critically ill adults. Intensive & Critical Care Nursing. 2011 Jun: p. 121-128. Available from:

Paulson-Conger M, Leske J, Maidl C, Hanson A, Dziadulewicz L. Comparison of two pain assessment tools in nonverbal critical care patients. Pain Management Nursing. 2011 Dec: p. 218-24. Available from:

Latorre MI, Solis MM, Acevedo NM. Validation of the behavioural indicators of Pain Scale ESCID for pain assessment in non-communicative and mechanically ventilated critically ill patients: a reserarch protocol. John Wiley & Son Ltd. 2015 Aug: p. 205-16. Available from:

Ramelet AS. Pain assessment in critical care: Instrument selection for nonverbal patients. Australian Critical Care. 2012 Aug: p. 275-7. Available from:

Vento-Wilson MT, McGuire A, Ostergren JA. Role of the speech-language pathologist augmentative and alternative communication for acute care patients with severe communication impairments. Dimensions of critical care nursing. 2015 Mar/Apr: p. 112-19. Available from: HTTPS://

Soderman M RS. Caring for ethnic older people living with dementia - experiences of nursing staff. Journal of cross-cultural gerontology. 2016 Sep: p. 311-26. Available from:

Hemsley B, Baladin S, Worrall L. Nursing the patient with complex communication needs: time as a barrier and a facilitator to successful communication in hospital. Journal of advanced nursing. 2011 Mar: p. 116-26. Available from:

Freitas FFQ, Lima JO, Oliveira CDB, et al. Consultation Performance of Nursing for the Elderly: Analysis based on the Theory of Hall. Journal of nursing UFPE. 2014 Dec: p. 4214-20.Available from:〈=pt-br&site=ehost-live.

Santos CMC PCNM. A estratégia PICO para a construção da pergunta de pesquisa e busca de evidências. Revista Latino-Americana de Enfermagem. 2007 Jun: p. 508-11. Available from:

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