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A new spiritual care communication board is helping patients in the intensive care unit (ICU) communicate their emotional and spiritual needs. The board, created by the Pastoral Care & Education Department at NewYork-Presbyterian/Columbia University Medical Center, is now available to hospitals and healthcare systems across the country.

“Spiritual care in the ICU is often focused on the family members of unconscious, dying patients, and patients who cannot talk either get no spiritual care or only whatever spiritual care other people assume they would want,” said Joel Nightingale Berning, a chaplain at NewYork-Presbyterian and creator of the spiritual care board. “The spiritual care board allows more patient-centered chaplaincy. The patients guide the spiritual support they truly want and need to cope with some of the most difficult experiences of their lives.”

The board displays words and illustrations that allow mechanically ventilated patients to indicate their preferences for spiritual care. Working with a chaplain, patients point to the words or illustrations that indicate their spiritual or religious affiliation, emotional state, spiritual needs and desired chaplain intervention. The overall purpose of the board is to reduce anxiety in patients and ensure they receive the most appropriate spiritual care.

Traditional communication boards have been used for more than a decade to help medical personnel obtain critical information from non-vocal patients who are in one of the many phases of ICU care. The boards allow patients who are alert but cannot speak to indicate a number of needs during their stay by pointing to letters, words or pictures in a variety of formats and languages. These clinical communication boards provide immediate feedback from the patient to the care team, providing more effective and focused care, while reducing the communications issues that can sub-optimize the ICU experience. While these clinical communication tools have played an extensive role in improving patient experience, they had never before been used for spiritual care.  

A recent study in the Annals of the American Thoracic Society (AnnalsATS) led by Chaplain Berning and Dr. Matthew R. Baldwin, attending physician in Critical Care Services at NewYork-Presbyterian/Columbia University Medical Center and assistant professor of medicine at Columbia University Medical Center, found that patients in NewYork-Presbyterian’s ICUs were able to complete the card with a chaplain’s assistance and receive a desired spiritual care intervention in a median time of 18 minutes. Patients reported a mean 31 percent immediate reduction in anxiety after receiving this care for the first time, and those who survived intensive care reported a reduction in stress that they attributed to picture-guided spiritual care.

The study authors indicate that more research on communication and psychoemotional suffering for patients in the ICU setting is needed, however using this unique spiritual assessment tool with ICU patients opens a novel area of chaplaincy and palliative care clinical research. The AnnalsATS also published an editorial saying that the spiritual care board “may also open the door to targeted psychoemotional assessments and interventions previously ignored or deemed ‘inappropriate’ due to communication barriers.”

“We heard from many patients that acknowledging their emotions with a chaplain was crucial in helping them cope with their critical illness,” said Dr. Baldwin. “We hope that with greater access to this tool, more patients will be able to express their spiritual needs in an effort to ease the emotional toll an ICU stay has.”

In accordance with established criteria of the Association of Professional Chaplains’ Standards of Practice as well as the authors’ clinical experience, NewYork-Presbyterian’s NYP Ventures arm has worked with Vidatak/Acuity Medical to produce the card in English and Spanish for hospital distribution across the U.S.

Author disclosures to the AnnalsATS paper are available within the study.

NewYork-Presbyterian

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