AKH Wien, Medical University of Vienna, Vienna, Austria.
AKH Wien, Medical University Campus, Vienna, Austria.
Nurs Crit Care. 2019 Nov;24(6):343-348. doi: 10.1111/nicc.12257. Epub 2016 Sep 21.
Diaries written for patients in the intensive care unit (ICU) are offered in many European countries. In Austria, ICU diaries have been relatively unknown, but since 2012, they have started to emerge.
The aim of this study was to explore the extent and application of ICU diaries in Austria in 2015.
The study had a prospective multiple methods design of survey and interviews. All ICUs in Austria were surveyed in 2015 to identify which ICUs used diaries. ICUs using diaries were selected for semi-structured key-informant telephone interviews on the application of ICU diaries. Interviews were analysed by content analysis.
Of the 178 ICUs contacted, 13 had implemented ICU diaries. In all ICUs, diaries were sporadically introduced by a few dedicated nurses. Experiences of participating nurses can be summarized in two main themes: (a) the process of innovation and (b) the process of practice. Sub-themes were: (i) inspiration, creativity and innovation and (ii) purpose, indications, responsibility, authorship, experience, negative reception, and post-ICU practice. Individual nurses at each ICU found ways to organize and format ICU diaries while dealing with ambivalence and legal implications.
The implementation of a new nursing intervention is an ongoing process. Being innovative and responsible can be challenging, especially in hierarchical team structures. We recommend that nurses work towards national standards for the diary concept in order to enable future research into the process and outcome of ICU diaries.
The implementation of ICU diaries in routine care requires an ongoing adaptive, reflective process. Nurses may experience innovation, leading to the development of their own, feasible adaptions and structures.
在许多欧洲国家，重症监护病房（ICU）为患者提供日记。在奥地利，ICU 日记相对不为人知，但自 2012 年以来，它们开始出现。
本研究旨在探讨 2015 年奥地利 ICU 日记的使用范围和应用情况。
该研究采用前瞻性调查和访谈的多方法设计。2015 年对奥地利所有 ICU 进行调查，以确定哪些 ICU 使用日记。对使用日记的 ICU 进行选择，对 ICU 日记的应用进行半结构化关键信息者电话访谈。访谈采用内容分析法进行分析。
在联系的 178 个 ICU 中，有 13 个实施了 ICU 日记。在所有 ICU 中，日记都是由少数敬业的护士零星引入的。参与护士的经验可以总结为两个主要主题：（a）创新过程和（b）实践过程。子主题为：（i）灵感、创造力和创新，以及（ii）目的、适应症、责任、作者、经验、负面反馈和 ICU 后实践。每个 ICU 的个别护士在处理矛盾和法律问题的同时，找到了组织和格式化 ICU 日记的方法。
实施新的护理干预措施是一个持续的过程。创新和负责可能具有挑战性，尤其是在等级制团队结构中。我们建议护士努力制定日记概念的国家标准，以便能够对 ICU 日记的过程和结果进行未来研究。
在常规护理中实施 ICU 日记需要持续的适应性、反思性过程。护士可能会经历创新，从而开发出自己可行的适应和结构。
