Intensive Care Unit Diaries: A Nurse-Led Program

Abstract

Background Following intensive care unit stays, patients with post–intensive care syndrome can experience mental health symptoms that impact quality of life. Intensive care unit diaries have been shown to improve outcomes for patients and their families. Local Problem Identification of limited support for high volumes of intensive care unit patients and families led to implementation of an intensive care unit diary program in a 24-bed adult medical-surgical intensive care unit. Methods Patients requiring mechanical ventilation with an expected intensive care unit stay of more than 24 hours were provided intensive care unit diaries. Nursing staff and patients’ families entered daily descriptive narratives of patients’ progress during the stay. After intensive care unit discharge, patients and families reviewed the diaries to improve acceptance of their intensive care unit experience. Project evaluation included review of patient and family follow-up calls, a staff nurse feedback survey, and project champion debriefing sessions to gauge implementation success and feasibility. Results Twenty diaries were completed and distributed to patients or families at intensive care unit discharge. Follow-up calls illustrated support and gratitude for diaries regardless of patient outcomes. Patients reported that diaries helped fill memory gaps between intensive care unit admission and discharge. Nurse surveys and project champion debriefings confirmed that completion of intensive care unit diary entries had minimal impact on workload, eased communication, and improved staff members’ coping skills. Conclusion Successful intensive care unit diary program implementation has the potential to benefit patients, families, and nursing staff for little organizational cost.