Implementation of an Intensive Care Unit Diary Program at a Veterans Affairs Hospital.
Kelly Drumright, Abigail C Jones, Ralph Gervasio and 3 others
PMID 32826699WHAT IT FOUND
In one ICU diary program, nurses wrote on 93% of diary days, non-nurse providers on 22%, and families on 32%.
Staff knowledge rose, but workload and legal worries also rose. No patient outcomes were tested.
Key findings
01Nurses made at least one entry on 93% of ICU diary days in the first 6 months, while non-nurse providers did so on 22% and family or visitors on 32%.
02Staff reported a 111% increase in mean ICU diary knowledge and a 91% increase in comfort educating families, but perceived workflow burden and legal concerns each increased by 10%.
03The project did not evaluate whether ICU diaries influenced outcomes associated with post-intensive care syndrome or family post-intensive care syndrome.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It was done in one Veterans Affairs ICU, so other units may need different processes. The project did not measure whether diaries changed post-intensive care syndrome or family post-intensive care syndrome. The staff survey was small and self-reported, with 20 respondents before implementation and 27 after. Diary compliance did not meet set goals, especially when the project leader was absent. Family and non-nurse participation were low. Patient and family perceptions of diaries were not evaluated.
The easy way to misread this
Do not conclude that ICU diaries reduce post-intensive care syndrome or improve family outcomes. This report measured diary uptake and staff perceptions, and it did not evaluate those patient or family outcomes.