Implementation and sustainability of an innovative ICU e-diary

Area of Science:

• Healthcare Innovation
• Digital Health Implementation
• Patient Communication Tools

Background:

• Traditional paper diaries in ICUs have limitations in data capture and accessibility.
• Electronic diaries (e-diaries) offer potential for improved patient communication and record-keeping in critical care settings.

Purpose of the Study:

• To evaluate the implementation of an e-diary in intensive care units (ICUs).
• To assess ICU staff uptake, family engagement, and perceived barriers and facilitators of e-diary use.
• To determine the acceptability, feasibility, and sustained use of e-diaries over time.

Main Methods:

• A service innovation and evaluation study using an e-diary (aTouchAway™) in four UK ICUs.
• Implementation involved a dedicated officer, education, reminders, and demonstrations over 8 months (Jan-Aug 2022).
• Data collected via pre-implementation audit, staff questionnaires (Acceptability and Feasibility of Intervention Measure - AIM/FIM), and post-implementation audits for sustained use.

Main Results:

• E-diary commencement rate averaged 65% during implementation, with 1242 entries from nurses, therapists, and family members.
• Staff found the e-diary generally easy to access (74%) and use (63%), with facilitators including reduced environmental impact and family participation.
• Barriers included the need for login/education and challenges for less technologically-competent families; sustained use showed a 63% commencement rate in June 2023.

Conclusions:

• The e-diary demonstrated moderate and sustained implementation success in ICUs.
• Key facilitators for e-diary adoption were identified, offering valuable insights for other centers.
• While some barriers exist, strategic approaches can enhance family engagement and overall e-diary implementation.