Implementation of an Intensive Care Unit Diary Program at a Veterans Affairs Hospital.

BACKGROUND: Intensive care unit (ICU) diaries are recommended to address psychological sequelae following critical illness. Diaries are correlated with reduced prevalence of posttraumatic stress disorder in survivors of critical illness and their families. LOCAL PROBLEM: Our ICU was not adequately meeting the psychological needs of patients and families. METHODS: We established an interprofessional team to implement an ICU diary program in partnership with implementation of the ABCDEF (Assess, prevent, and manage pain; Both awakening and breathing trials; Choice of analgesia and sedation; Delirium: assess, prevent, and manage; Early mobility and exercise; Family engagement and empowerment) bundle and peer support programs. Staff knowledge and perception of ICU diaries were obtained. INTERVENTIONS: Diaries were initiated for patients at high risk for post-intensive care syndrome, and entries by all ICU staff and family members/visitors were encouraged. RESULTS: A total of 75 diaries were initiated between January 2017 and January 2019. The ICU diaries have been received positively by patients, family members, and staff. CONCLUSIONS: The ICU diary is a cost-effective and efficient intervention to help patients and family members cope with the burden of critical illness.

Implementation of a Patient and Family-Centered Intensive Care Unit Peer Support Program at a Veterans Affairs Hospital.

Peer support is a novel strategy to mitigate postintensive care syndrome and postintensive care syndrome-family. This project implemented a peer support program to address postintensive care syndrome for patients and family members. Using a free-flow, unstructured format, a chaplain, social worker, nurse, and intensive care unit survivor led veterans and loved ones in discussion of intensive care unit experiences, fears, and the challenges of recovery. Evaluations indicated group participation is beneficial for emotional support, coping, and understanding common situations related to prolonged intensive care unit stay. A majority reported they would strongly recommend group participation to a friend.