Communication vulnerable patients in the pediatric ICU: Enhancing care through augmentative and alternative communication.

Children in pediatric intensive care units (PICUs) may experience a broad range of motor, sensory, cognitive, and linguistic difficulties that make it difficult for them to com municate effectively. Being unable to communicate is emotionally frightening for children and can lead to an increase in senti nel events, medical errors and extended lengths of stay. Implementation of augmentative and alternative communication (AAC) tools and strategies can address the communication needs of children in the PICU by enabling them to communicate their wants, needs and feelings to healthcare providers and family members and participate in their own care more productively. Hospitals around the world are increasingly recognizing and addressing patients' needs for communication access and h ave begun to implement communication screenings and assessments and interventions at admission and throughout the hospital stay. New standards for all American hospitals, in fact, mandate efforts to improve patient communication. When patient-provider communication improves, treatment success goes up, hospital-caused errors decrease and patient and family satisfact ion improve. This article describes three phases of intervention for com munication vulnerable children in the PICU and provides examples of treatment approaches that ensure communication access as their medical condition changes.