重症监护病房日记：一种护士主导的项目。

Intensive Care Unit Diaries: A Nurse-Led Program.

机构信息

Abbygale Hackenberger is an assistant teaching professor at the Pennsylvania State University Ross and Carol Nese College of Nursing, Hershey, Pennsylvania, and clinical education specialist at the University of Pittsburgh Medical Center, Central Pennsylvania.

出版信息

Crit Care Nurse. 2023 Feb 1;43(1):20-30. doi: 10.4037/ccn2023573.

DOI:10.4037/ccn2023573

PMID:36720281

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.

摘要

背景

在重症监护病房（ICU）停留后，患有 ICU 后综合征的患者可能会出现影响生活质量的心理健康症状。已证明 ICU 日记可改善患者及其家属的预后。

当地问题

由于 ICU 患者和家属数量众多，导致对他们的支持有限，因此在一个拥有 24 张病床的成人综合 ICU 中实施了 ICU 日记项目。

方法

需要机械通气且预计 ICU 入住时间超过 24 小时的患者将获得 ICU 日记。护理人员和患者家属每天都会记录患者在入住期间的病情进展情况。在 ICU 出院后，患者和家属会查看日记，以提高对 ICU 经历的接受程度。项目评估包括对患者和家属随访电话、护士反馈调查以及项目负责人的汇报会议的审查，以评估实施的成功和可行性。

结果

完成了 20 份 ICU 日记并在 ICU 出院时分发给患者或家属。随访电话表明，无论患者的结局如何，日记都得到了支持和感谢。患者报告说，日记帮助填补了他们从 ICU 入院到出院之间的记忆空白。护士调查和项目负责人的汇报会议证实，完成 ICU 日记条目对工作量的影响很小，有助于沟通，并提高了工作人员的应对技能。