Determinants of digital ICU diary implementation and use by ICU professionals: A cross-sectional survey analysis.

Abstract

Objectives: To identify the key determinants for implementing and utilizing a digital intensive care unit (ICU) diary among ICU professionals.

Background: Despite the advantages of digital diaries over traditional paper ones, their implementation presents challenges that necessitate tailored strategies considering the influencing factors.

Design: A multicentre, cross-sectional survey study.

Methods: A self-developed questionnaire was administered from March to May 2023, targeting ICU professionals across four hospitals in the Netherlands. Participants rated the relevance of 34 determinants on a 5-point Likert scale across four domains: (1) Digital diary introduction and use, (2) Education and information dissemination, (3) Offering the digital diary to patients' relatives, and (4) Professionals' engagement in diary writing.

Results: Responses were received from 214 professionals. The most commonly agreed-upon determinants promoting implementation were seamless accessibility (n = 200; 93.5 %), enthusiastic and motivating champions (n = 190; 88.8 %), and comprehensive information and education (n = 184; 86 %). The preferred method for disseminating information was direct instruction from champions in the teams (n = 194; 90.7 %). Promoting factors for providing digital diaries to relatives included understanding its utility (n = 203; 94.9 %) and recognizing its added value (n = 193; 90.2 %). Additionally, 132 professionals (61.7 %) expressed a positive attitude towards co-writing the digital diary.

Conclusion: This study identified key determinants promoting the implementation and utilization of digital diaries in ICUs among professionals. These findings lay a foundation for developing strategies to address challenges and enhance the successful implementation of digital diaries in ICU settings.

Implications for clinical practice: To maximize the impact of digital diaries, it is essential to involve end users early and tailor the design for ease of use. Selecting influential champions is key, and they should receive training to lead and mentor others. Clear communication of the benefits for patients and families will foster professionals' understanding and motivation, ultimately enhancing patient care.