Department of Health and Caring Sciences, Western Norway University of Applied Sciences, Norway.
Department of Nursing and Health Promotion, Oslo Metropolitan University, Norway.
Intensive Crit Care Nurs. 2020 Aug;59:102828. doi: 10.1016/j.iccn.2020.102828. Epub 2020 Mar 5.
To evaluate critical care nurses' experiences of ICU diaries following the implementation of national recommendations for the use of diaries for critically ill patients.
A quality improvement project describing the development and implementation of national recommendations (2011), as well as the assessment of the use of diaries in intensive care nursing practice (2014).
Norwegian intensive care units (ICUs).
Thirty-nine Norwegian ICUs took part in the study.
A multi-component process for developing national recommendations for the use of diaries in Norwegian ICUs, including recommendations for the target group, when to start, health professionals as authors, diary content, structure, language, use of photographs, handover, access and storage within patient medical records.
A questionnaire asking about experiences of implementing national recommendations on diaries in Norwegian ICUs, as well as their impact and how they are used.
Three years after the implementation of the national recommendations, diaries were provided in 24 (61.5%) of the responding ICUs. Fifty-six per cent of the ICUs had revised their routines, of which 62% had updated and 38% had developed new protocols. Most ICUs kept the diary along with other medical information describing patient care, but only 50% of the ICUs scanned handwritten diaries into the electronic medical records before handing them over to patients or the bereaved. ICU nurses reported that implementing national recommendations had increased their awareness and knowledge on patient and family needs, as well as the long-term effects of critical illness.
The results of this quality improvement project indicate that access to national recommendations on the use of diaries for critically ill patients have a potential of changing routines and increase standardisation.
评估在实施国家推荐意见后，重症监护病房护士对 ICU 日记的使用体验，该推荐意见为危重症患者使用日记提供了指导。
质量改进项目，描述了国家推荐意见（2011 年）的制定和实施，以及对重症监护护理实践中日记使用情况的评估（2014 年）。
挪威重症监护病房（ICU）。
39 家挪威 ICU 参与了该研究。
一个多步骤的流程，为挪威 ICU 中使用日记制定了国家推荐意见，包括目标人群、开始时间、健康专业人员作为作者、日记内容、结构、语言、照片使用、交接、在患者病历中的获取和存储。
一份问卷，询问挪威 ICU 实施国家推荐意见的经验，以及其影响和使用情况。
在实施国家推荐意见的 3 年后，有 24 家（61.5%）参与调查的 ICU 提供了日记。62%的 ICU 修改了常规，其中 62%更新了常规，38%制定了新的方案。大多数 ICU 将日记与其他描述患者护理的医疗信息一起保存，但只有 50%的 ICU 在将手写日记交给患者或其家属之前将其扫描到电子病历中。ICU 护士报告称，实施国家推荐意见提高了他们对患者和家属需求以及危重病长期影响的认识和了解。
本质量改进项目的结果表明，获取国家推荐意见可能会改变危重症患者使用日记的常规，增加标准化程度。
