Patient diaries

Intensive care patient diaries are a simple but valuable tool in helping patients come to terms with their critical illness experience.

Patients who've had a stay in ICU may be kept sedated for some time while they're mechanically ventilated. After discharge from ICU they often report having gaps in their memory from their illness or they may remember nightmares, hallucinations or feelings that people were trying to hurt them. A recent innovation to help fill this memory gap and help patients to understand what has happened is an ICU diary. This diary is written for ICU patients by healthcare staff, particularly nurses and family members and friends. Photographs may also be taken at points of change in the patients' condition and added to the diary when it is returned to the patient.

The diary is written in everyday language and contains daily entries on the patients' condition. The patients' family are encouraged to also write about what is happening at home as there may be important events there that the patient is missing. It is usually written directly addressing the patient. The diary is given to the patient after they are discharged from the ICU and is then their property to take home with them and read at their own pace to understand what has happened in ICU if they want to.

Research has shown that patients and relatives generally find a diary valuable, and enable patients to make sense of their intensive care experiences. In addition studies have shown that receiving an ICU diary reduces the risk of developing depression, anxiety and Post Traumatic Stress Disorder for both patients and relatives.

The ICU diary network was established in 2012 and has as its aim the establishment of an informal group for health care workers who are interested in using ICU diaries. The network was founded by a group of ICU nurses from different countries across Europe, Eva Akerman, Carl Bäckman, Ingrid Egerod, Christina Jones, Dirk Knück, Peter Nydahl and Sissel Storli. The site contains an extensive list of literature about diaries and has information to help staff with implementation, such as guidelines. The diary network aims to co-ordinate information, projects and new studies and connect people who may need further help. There's also a map showing where diaries have been implemented and contact details of staff in each ICU.

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