Developing a framework for implementing intensive care unit diaries: a focused review of the literature.
Muna Beg, Elizabeth Scruth, Vincent Liu
PMID 27240937WHAT IT FOUND
ICU diaries can help patients fill memory gaps, and an included randomised trial reported fewer PTSD symptoms at 3 months, but evidence is low quality and diary return timing varies.
Key findings
01ICU diaries were commonly handwritten paper notebooks kept at the bedside, using photographs, standard headings, everyday events, and non-medical language.
02The largest differences between studies were the timing and method of diary return, including return at discharge or 1-3 months after discharge.
03The review rated the evidence for implementing ICU diaries as low quality and found no follow-up beyond 18 months.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review included only 25 studies, and the authors rated the evidence for implementing ICU diaries as low quality. Most included studies were from a few European countries, so the framework may not transfer directly to other health systems. Only one reviewer assessed study quality, which may make bias judgments less reliable. The included studies did not fully describe diary timing, staff training, or safe return methods. Many studies excluded patients with cognitive impairment, prior psychiatric illness, visual impairment, or language barriers, so it is unclear how diaries would work for those groups. No included study followed patients beyond 18 months, and adverse effects of diaries were not established. All diaries were handwritten paper notebooks, so the review does not show how electronic diaries would work.
The easy way to misread this
Do not conclude that ICU diaries are proven to reduce PTSD or improve recovery. The review rated the evidence low quality, diary methods varied widely, and no included study followed patients beyond 18 months.