• Julie Rogan, Megan Zielke, Kelly Drumright, and Leanne M Boehm.
• Julie Rogan is a clinical nurse specialist pursuing a Doctorate of Nursing Practice degree at the University of Pennsylvania, Philadelphia.
• Crit Care Nurse. 2020 Oct 1; 40 (5): 47-56.

BackgroundAlthough diaries are an evidence-based practice that improves the quality of life of patients in an intensive care unit and their loved ones, centers in the United States are struggling to successfully implement diary programs in intensive care units. Currently, few published recommendations address how to facilitate implementation of a diary program, and how to effectively sustain it, in an intensive care unit.ObjectivesTo discuss challenges with implementing diary programs in intensive care units at 2 institutions in the United States, and to identify solutions that were operationalized to overcome these perceived difficulties.MethodsThe teams from the 2 institutions identified local barriers to implementing diaries in their intensive care units. Both groups developed standard operating procedures that outlined the execution and evaluation phases of their implementation projects.ResultsBarriers to implementation include liability and patient privacy, diary program development, and implementation and sustainability concerns. Various strategies can help maintain clinical and family member engagement.ConclusionThrough a team's sustained dedication and a diligent assessment of perceived obstacles, a diary program can indeed be implemented within an intensive care unit.©2020 American Association of Critical-Care Nurses.

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