1. Using an alternative nurse call Iowa Adaptive Technologies Fall 2015 ™ Iowa Adaptive Technologies

2. The First Part Of Patient-Provider Communication: Accessing The Nurse Call System All conscious patients should have access to the nurse call system. – Standard nurse call pendant – Standard alternative switches Pressure plate Pressure bulb Patients who lack the motor skills to use the pendant or alternative switches need some form of assistive technology to access the call system. Iowa Adaptive Technologies

3. First step: Determining if a patient has an intentional gesture and selecting a switch Identify the voluntary gesture that the patient can produce. – What is a gesture? Any motor response a patient can make on command Any motor response a patient can make repeatedly – Types of gestures tongue click pushing tongue into cheek lip squeeze wink or eye blink head or jaw movement Iowa Adaptive Technologies

4. First step: Determining if a patient has an intentional gesture and selecting a switch

5. Second Step: Finding a transducer that can detect the intentional gesture Gestures with an audible component – Microphone Gestures with a minimal movement and very limited force – Proximity sensor Gestures with minimal movement and force – Pressure sensor Winking or blinking – Infrared sensor Iowa Adaptive Technologies

6. Third Step: Plugging in and Positioning the Noddle™ Attach Noddle™ to IV pole using IV pole clamp Video: Positioning the Noddle™ on IV pole Plug in the Noddle™ within 1.8 meters (6 feet) of standard 120V AC power outlet Video: Plugging in the Noddle™ Connect Noddle™ to Nurse Call Video: Connecting the Nurse Call

7. Third Step: Positioning the switch to allow the patient continuous access Always keep the alternative switch positioned where the patient can access it. – Nurse call pendant where patient can reach it – Alternative switches where patients can access them Video: Noddle Mic™ Positioning Video: Noddle Touch™ Positioning Mounting options – Clip to bedding – Clip to patient gown – Clip to vent line Video: Noddle Mic™ on Vent Line – Clip to halo – Clip to Miami-J collar Video: Noddle Mic™ on Miami-J – Clip to eye glasses Video: Noddle Touch™ on Miami-J Iowa Adaptive Technologies

8. All conscious patients should have a way to communicate with their caregivers and participate in their care. Speech-generating devices provide an option for patients who cannot use normal oral and written forms of communication. – Direct Selection using a touch screen for patients with use of their hands – Scan Selection using switches for patients with limited motor skills The Second Part Of Patient-Provider Communication: Accessing A Speech-Generating Device Iowa Adaptive Technologies

9. The Second Part Of Patient-Provider Communication: Accessing A Speech-Generating Device

10. First Step: Selecting How A Patient Accesses The Speech-Generating Device Speech Generating Devices are available from the study coordinator or from the UIHC Speech & Swallowing Service Determine if the patient can use Direct Select Method If the patient cannot use Direct Select then select a Switch Scanning Method – Make connection to the Speech-Generating Device Hardwired versus Bluetooth Video: Connecting the Noddle™ with Bluetooth Iowa Adaptive Technologies

11. Preset communication templates Iowa Adaptive Technologies has created noddle chat™, a set of templates for use by patients that are available on SGD devices. Contact project staff or the Speech & Swallowing Service for assistance. On Screen Keyboard The on screen keyboard with word prediction allows patients to create novel messages “on the fly” Position SGD so that it is always in the line of sight of the patient Video: Positioning the SGD Second Step: Selecting Content For The Speech- Generating Device Iowa Adaptive Technologies

12. Second Step: Selecting Content For The Speech- Generating Device Noddle Chat – Two switch scanning: one gesture to select row and two gestures to select icon – Three vocabularies (i.e. Start Set, Basic Set, Full Set w/ or w/o EOL) Video: Two Switch Scanning

13. Noddle TM Instructions Troubleshooting & Support A Noddle User Manual with instructions and troubleshooting tips is distributed with the Noddle™ For online instructional videos, visit www.voxello.com/training www.voxello.com/training For online technical support please visit www.voxello.com/support www.voxello.com/support For assistance over the telephone, please call 319- 382-5459 between the hours of 8 AM and 5 PM CST Monday through Friday. Iowa Adaptive Technologies