Hospital staff views on communication in hospital (Children with Cerebral Palsy)

Speech Pathology Australia National Conference 24-27 June 2012

Hospital staff views on communicating with children with cerebral palsy and complex communication needs in hospital: Environmental barriers and solutions to improve communication.

Kathleen Munro (1), Nadeera Seedat (2), Kaely Bastock (3), Bronwyn Hemsley (1,3)

(1) The University of Queensland, (2) Cerebral Palsy League, QLD, (3) The University of Newcastle, Australia

The aims of this focus group study were to investigate the views of hospital staff on (a) the communication needs and methods of children with cerebral palsy (CP) and complex communication needs (CCN) in hospital, (b) their roles in supporting these children, and (c) barriers to and strategies for better communication on the ward. Participants included allied health professionals and nurses who had worked with children with CP and CCN. There was agreement across the data that children with CP and CCN in hospital need to communicate basic needs and preferences for leisure activities. Most participants reported relying upon parents to communicate with the child. Although allied health staff considered parents would be present at most times, nurses reported that this did not always occur. Barriers to the child’s use of augmentative and alternative communication (AAC) systems included lack of space at the bedside, lack of a means to store and protect a costly AAC system, and lack of staff confidence and knowledge in how the child communicated outside the hospital. One focus group of nurses reflected that barriers to the use of AAC had been removed in order to enable children to use their own AAC systems. This group reported that simple and complex high technology AAC systems were viable for use in hospital wards if environmental supports are in place. In this paper, barriers to and strategies for better communication in hospital will be presented and policy and practice implications for hospital staff discussed.

Communication Disability and Adverse Events in Hospital: Aphasia (Pilot Study)

Conference abstract accepted:

Speech Pathology Australia National Conference, Hobart, 24-27 June 2012

Adverse events in hospital as reported by adults with aphasia and their spouses: A pilot study.

Maryanne Wernincke (1), Linda Worrall (1), Bronwyn Hemsley (2)

(1) The University of Queensland; (2) The University of Newcastle


Adults with communication disability have a three-fold increased risk for preventable and multiple adverse events in hospital (Bartlett et al., 2008). However, little is known about the patient safety incidents of adults with aphasia. Saxena, Ng, Yong, Fong, and Gerald (2006) found that stroke patients often experience preventable and harmful patient safety incidents, including falls and skin sores, during hospitalization. Increased duration of stay in hospital is associated with an increased risk of patient safety incidents (Andrews et al., 1997) and stroke patients who have increased duration of stay in hospital or who suffer a patient safety incident in hospital are at a higher risk of rehospitalisation (Lin, Chang, and Tseng 2011). To date, there is little information available on the experiences of adults with aphasia relating to adverse events in hospital. The aims of the study are to (a) describe the experiences of adults with aphasia secondary to stroke and their carers/family members in relation to patient safety incidents experienced in hospital since stroke, (b) identify the situations, people, events, and outcomes relevant to the patient safety incident, and (c) look for commonalities in stories of experiences that would inform the prevention or better management of patient safety in stroke patients with aphasia.

Communication in Hospital and the ICF – Results from Child and Adult Studies

International Society for Augmentative and Alternative Communication

#ISAAC2012 @ISAAC_2012 Pittsburgh, USA End July 2012

Title and author details

Using the ICF as a framework to support effective communication between people with CP and CCN and their communication partners in hospital settings.

Authors: Bronwyn Hemsley, Susan Balandin, Melanie Fried-Oken, Linda Worrall.



Effective communication in hospital is central to the provision of healthcare and is built upon interactions between the patient and the provider along with caregivers (Joint Commission, 2010). However, both children and adults with cerebral palsy (CP) and complex communication needs (CCN) struggle to communicate with staff who are not familiar with their communication needs and methods. People who use AAC do not typically take their own AAC systems to hospital, and often rely upon a third party (e.g., family member or paid caregiver) for their communication with hospital staff. Despite the availability of low technology communication aids for use in hospital, environmental barriers preventing their use persist (Hemsley et al., 2011a,b,c). An in-depth understanding of factors affecting communication in hospital according to the ICF is needed to inform the design of interventions to influence uptake and use of AAC tools made available for communication in hospital.



The aim of this study was to investigate communication between children and adults with CP and CCN and their communication partners in hospital to determine: (a) common communication needs, (b) barriers to or strategies to effective communication using AAC in hospital, and (c) the roles of health professionals and carers in supporting communication and preparing for hospitalization. In this paper we will present an overview of the research findings in relation to content themes and factors within the International Classification of Functioning, Disability, & Health (ICF, WHO, 2001) to inform clinical, educational, and research directions in improving communication in hospital.