基于证据的、以患者为中心的实践的机构挑战与解决方案：实施 ICU 日记。
Institutional Challenges and Solutions to Evidence-Based, Patient-Centered Practice: Implementing ICU Diaries.
机构信息
Julie Rogan is a clinical nurse specialist pursuing a Doctorate of Nursing Practice degree at the University of Pennsylvania, Philadelphia.
Megan Zielke is a critical care clinical pharmacy specialist, Penn Presbyterian Medical Center, Philadelphia, Pennsylvania.
出版信息
Crit Care Nurse. 2020 Oct 1;40(5):47-56. doi: 10.4037/ccn2020111.
BACKGROUND
Although diaries are an evidence-based practice that improves the quality of life of patients in an intensive care unit and their loved ones, centers in the United States are struggling to successfully implement diary programs in intensive care units. Currently, few published recommendations address how to facilitate implementation of a diary program, and how to effectively sustain it, in an intensive care unit.
OBJECTIVES
To discuss challenges with implementing diary programs in intensive care units at 2 institutions in the United States, and to identify solutions that were operationalized to overcome these perceived difficulties.
METHODS
The teams from the 2 institutions identified local barriers to implementing diaries in their intensive care units. Both groups developed standard operating procedures that outlined the execution and evaluation phases of their implementation projects.
RESULTS
Barriers to implementation include liability and patient privacy, diary program development, and implementation and sustainability concerns. Various strategies can help maintain clinical and family member engagement.
CONCLUSION
Through a team's sustained dedication and a diligent assessment of perceived obstacles, a diary program can indeed be implemented within an intensive care unit.
背景
尽管日记是一种基于证据的实践，可以提高重症监护病房患者及其家属的生活质量，但美国的一些中心在重症监护病房成功实施日记项目方面仍面临困难。目前，很少有已发表的建议涉及如何在重症监护病房中促进日记项目的实施，以及如何有效地维持该项目。
目的
讨论美国 2 家机构在重症监护病房实施日记项目所面临的挑战，并确定为克服这些问题而实施的解决方案。
方法
这 2 家机构的团队确定了在其重症监护病房实施日记的本地障碍。这两个小组都制定了标准操作程序，概述了实施项目的执行和评估阶段。
结果
实施障碍包括责任和患者隐私、日记项目开发以及实施和可持续性问题。各种策略可以帮助维持临床和家庭成员的参与度。
结论
通过团队的持续投入和对感知障碍的认真评估，确实可以在重症监护病房中实施日记项目。
Zotero 插件