Intensive care unit is an area which creates fear and worries in client and relatives while nurses working in this area undergo stress to overcome, this there is a need for the nurse to understand the importance of communication in an Intensive care Unit . Communication skills are relatively poorly developed among critical care nurses compared to nurses in wards.1 Objective- It was to enhance communication between the nurse and client by assessing the effectiveness of Standard Operating Protocol on practices of nurses regarding communication with the clients and relatives in intensive care unit at selected hospitals in the state of Maharashtra as there were no protocols existing in the intensive care unit for nurses. Method and Statistical analysis- A descriptive evaluative approach, Pre experimental time series one group pretest post-test design was used. Total of 220 nurses selected by purposive sampling technique. Tools were Standard Operating Protocols. Teaching Module, An observation checklists with socio-demographic data. Observation technique was used to observe the practices. Data were analyzed using both descriptive and inferential statistics. The result of the study showed. There was a significant association of educational qualification with post-test-1 observational practices as p = < 0.0001. There was no association with observed practice score and socio-demographic data during pretest and posttest- 2. In Communication with client Area of nonverbal communication improved from 41% to 91%. Reassurance and comfort also increased from 41% to 84%. Communication with client’s relatives enhanced from 43% to 93% in the majority as an aspect of the checklist.

Dr. Sangeetha Sunil Bhujbal ."The Study of Development of Standard Operating Protocols for Nurses With Reference To Communication with Client and Relatives in the Intensive care Unit (ICU)". International Journal of Computer Engineering In Research Trends (IJCERT) , ISSN:2349-7084, Vol.7, Issue 08,pp.11-19, August - 2020, URL:http://ijcert.org/ems/ijcert_papers/V7I803.pdf,

1.	Park Y, Oh EG. Factors related to intensive care unit nurses’ patient centered communication competency. J Korean Crit Care Nurs. 2018; 11:51–62.
2.	Mary Beth Happ, Kathryn Garrett, Dana DiVirgilio Thomas,  Judith Tate, Elisabeth George,     MartinHouze,  Jill Radtke, Susan Sereika, Nurse-Patient Communication Interactions in the intensive Care Unit, American Journal of Critical Care March 2011 vol. 20 no. 2 e28-e40.
3.	Enrique Rivero, Communication Board Can Ease Frustration Intubated Patients Feel When Trying to Convey Their Needs, American Journal of Critical Care UCLA November 28, 2006.
4.	GrazinaWojnicki-Johansson , Communication between nurse and patient during ventilator treatment: patient reports and Registered Nurse Response. Intensive Critical Care Nursing Journal. 2000 Jun; 12(3):167-80. 
5.	Judith E Hupcey. The psychological needs of the ICU patients, Journal of Nursing Scholarship 2000; vol 32(4) 361-367. 2007
6.	Cazorla C, Cravoisy A, Gibot S, Nace L, Levy B, Bollaert PE. Patients' perception of their experience in the intensive care unit. . 2007 Feb; 36(2):211-6. Epub 2006 Dec 20.
7.	Polit F Denise, Beck Tatanocherly. Nursing Research: Generating and Assessing Evidence for Nursing Practice.8th ed. New Delhi: Wolters Kluwer Pvt. Ltd, 2008.
8.	Burns Nancy, Grove Susan. Understanding Nursing Research: Building an Evidence Based Practice.4th ed. Noida: Elsevier India Private Limited, 2007.  
9.	Wanga S.K.L. and Leweshow S. “Sample size determination in health studies”, Publication World Health Organization Geneva 1991 pg -125-27.
10.	Suresh K Sharma: Nursing Research & Statistics. Reed Elsevier India Private Ltd.2011B.T 
11.	Black. J. M and Matassarin, J. Medical Surgical Nursing Psychophysiological Approach, Philadelphia: W.B.Saunders and Company. 1993.
12.	Richard J. Wall, Robert’s, Ditter& E Waley Ely. Protocol driven care in the intensive care unit: a tool for quality. http:/ccforum.com/content 5/6/283.