Project Description

The SPEACS-2 training program was developed from a series of research studies (See Resources tab for publications from the studies). The SPEACS projects are a multidisciplinary effort to improve communication with patients in the intensive care unit (ICU) who are unable to speak because an artificial airway (oral or tracheostomy) is in place. These patients may also require mechanical ventilation (respirator) and sedating medications that make thinking and communication more difficult.

Communication difficulty is a frightening and frustrating problem and is one of the most common and most distressing symptoms reported by mechanically ventilated ICU patients. Nurses, speech language pathologists, physicians, respiratory therapists, and others are working together to address this problem and to improve the experience and quality of critical care for patients and families.*

The SPEACS program consists of communication skills training for caregivers, the provision of communication tools and expert consultation by a speech language pathologist. 

The first study (SPEACS) was funded by a grant from the National Institute of Child Health and Human Development (5R01-HD043988) to test the effect of a multi-level communication intervention on nurse-patient communication performance (success, frequency, ease, quality) with non-vocal patients in the ICU. Nurses received a 4 or 6 hour training program, communication materials.  In addition, one group received speech language pathologist consultation and electronic communication devices.

SPEACS-2 is a translational study, funded by the Robert Wood Johnson Foundation INQRI program, to test the impact of an on-line training course for nurses and communication tools program (SPEACS-2) on patient care outcomes: nursing care quality and on patient / family satisfaction with communication. We also tested nurses knowledge, comfort and satisfaction regarding communication with nonvocal ICU patients.

SPEACS-2 utilizes a web-based course, pocket reference guides, instructional manual, “low-tech” communication materials and bedside communication rounds led by a speech language pathologist to train ICU nurses on communication techniques for use with non-vocal patients. 

*For a further description of communication difficulty as a serious clinical care problem in the ICU and practice solutions, see;;