Recommended Citation
Esposito L. Implementation of a pediatric intensive care unit diary. Evidence Based Practice poster presentation at Empowering Nursing Excellence: Recognizing the Value and Impact of Nurses, Advocate Health Midwest Region Nursing Research & Professional Development Conference 2023; November 15, 2023; virtual.
Presentation Notes
Evidence Based Practice poster presentation at Empowering Nursing Excellence: Recognizing the Value and Impact of Nurses, Advocate Health Midwest Region Nursing Research & Professional Development Conference 2023; November 15, 2023; virtual.
Abstract
Background: Critical illness and the PICU environment may contribute to the development of Post Intensive Care Syndrome (PICS) in children, their parents, or their siblings. PICS has a negative impact on quality of life, including development of PTSD, reduced school performance, or delay in meeting developmental milestones. Diaries have been used to create context and memory after discharge, extending cognitive and emotional support beyond the PICU stay. Entries are staff-written in letter format, including details about the patient’s day, events, or feelings. The diaries become a supportive tool for the patient and family on their journey post critical illness.
Purpose: The purpose of the evidence-based practice (EBP) project was to plan, implement, and evaluate Nursing acceptance of a PICU diary. Specifically, this EBP project addressed the following question: For registered nurses in the pediatric intensive care unit (P), what are facilitators and barriers (I) to implementation of PICU diary?
Implementation: The project was implemented using PDSA cycles. Diaries were initiated for English-speaking patients with an expected length of stay of at least three days. The project leader rounded on nurses caring for patients with diaries to solicit barriers and facilitators of diary use. Each cycle resulted in changes to population, communication, or process.
Outcomes: Twelve diaries were deployed to patients between two weeks of life to 15 years of age. The primary barriers were uncertainty about what to write and fear of entry comparison.The primary facilitators were creating a meaningful entry and feeling that the diary extended nursing care beyond the PICU. Experienced nurses also indicated that writing in the diary helped them process challenging experiences.
Implications for Practice: New graduate PICU nurses need more writing support to feel confident in their entries. The link between diary entry and nursing resilience should be further explored.
Document Type
Poster
Publication Date
11-15-2023
Implementation of a pediatric intensive care unit diary
Background: Critical illness and the PICU environment may contribute to the development of Post Intensive Care Syndrome (PICS) in children, their parents, or their siblings. PICS has a negative impact on quality of life, including development of PTSD, reduced school performance, or delay in meeting developmental milestones. Diaries have been used to create context and memory after discharge, extending cognitive and emotional support beyond the PICU stay. Entries are staff-written in letter format, including details about the patient’s day, events, or feelings. The diaries become a supportive tool for the patient and family on their journey post critical illness.
Purpose: The purpose of the evidence-based practice (EBP) project was to plan, implement, and evaluate Nursing acceptance of a PICU diary. Specifically, this EBP project addressed the following question: For registered nurses in the pediatric intensive care unit (P), what are facilitators and barriers (I) to implementation of PICU diary?
Implementation: The project was implemented using PDSA cycles. Diaries were initiated for English-speaking patients with an expected length of stay of at least three days. The project leader rounded on nurses caring for patients with diaries to solicit barriers and facilitators of diary use. Each cycle resulted in changes to population, communication, or process.
Outcomes: Twelve diaries were deployed to patients between two weeks of life to 15 years of age. The primary barriers were uncertainty about what to write and fear of entry comparison.The primary facilitators were creating a meaningful entry and feeling that the diary extended nursing care beyond the PICU. Experienced nurses also indicated that writing in the diary helped them process challenging experiences.
Implications for Practice: New graduate PICU nurses need more writing support to feel confident in their entries. The link between diary entry and nursing resilience should be further explored.