Improving patient diary use in intensive care: A quality improvement report

Abstract

Background Patients surviving critical illness are at risk of developing psychological symptoms that affect quality of life and recovery. Patient diaries may improve psychological outcomes by reducing gaps in memory and contextualising what has happened during admission. Factors including lack of guidelines, lack of awareness and time constraints may lead to poor diary use. Aims This quality improvement project aimed to increase diary provision and overall multidisciplinary team engagement with diaries for all patients admitted for over 72 h to an intensive care unit. Methods Trialled changes implemented via the ‘Plan-Do-Study-Act’ method included adding alerts to the online patient note system, providing education sessions and introducing a guidance document to facilitate entry completion. Results A ‘diary provision’ target of 100% was achieved (from a baseline of 26.1%). Simple changes have proven effective in establishing routine engagement with diaries, and lessons may be used to improve diary systems elsewhere.

Improving Rehabilitation Information-Giving to Intensive Care Unit Survivors to Aid in Physical and Psychological Recovery

“…However, this was expected given the inclusion criterion of being at increased risk of morbidity, which leads to the non-inclusion of patients with ICU stays too short to confer a high morbidity risk, very long-term admissions that were not discharged during the study period and naturally those who passed away in the hospital or shortly after discharge. Nevertheless, the sample size was comparable to that reported in a previous study in the unit, if the above factors and failure to reach patients are taken into account [7].…”

“…1 2 3 4 This project was undertaken in the Medway Maritime Hospital ICU in Kent, South-East England. Prior to the start of this study, patients were given diaries during their stay, following a previous project [7]. This aimed to refresh patients' memory and improve long-term psychological outcomes.…”

Effect of intensive care unit diary on quality of life of intensive care unit survivors and their relatives: A systematic review and meta‐analysis

“…Studies of diaries as non‐pharmacological interventions for PICS are gaining attention. Recent studies have shown that ICU diaries help facilitate the reproduction and reconstruction of patients' memories and improve their prognosis and QoL (Ullman et al, 2015 ; Veloso Costa et al, 2021 ). Two recent meta‐analysis results reported improvement in the QoL‐GH of ICU survivors (Barreto et al, 2019 ; McIlroy et al, 2019 ) and another meta‐analysis conducted a descriptive analysis of QoL.…”

“…But the efficacy of ICU diaries on relatives' QoL was not found.Studies of diaries as non-pharmacological interventions for PICS are gaining attention. Recent studies have shown that ICU diaries help facilitate the reproduction and reconstruction of patients' memories and improve their prognosis and QoL(Ullman et al, 2015;Veloso Costa et al, 2021). Two recent meta-analysis results reported…”

Multilingual Framework for Risk Assessment and Symptom Tracking (MRAST)

“…Also from a practical perspective, the main barrier to a sustainable collection of PROs relates to engagement, which denotes disinterest and lack of time and comprehension. The digital diaries can improve the patient experience and decrease anxiety [ 69 ]. Using semi-structured and unstructured digital diaries with open-ended questions (i.e., interviews) represents an efficient alternative method of collecting patient experiences and outcomes [ 70 ].…”