Evidence Mapping of ICU Diary Implementation: A Comprehensive Scoping Review

Introduction: Intensive care unit (ICU) diaries are an effective tool used to improve patient and family outcomes but their integration into clinical practice remains challenging. The aim of this scoping review is to address the current knowledge gap regarding ICU diary implementation by identifying existing implementation practices across clinical settings.


Methods: We conducted a librarian-assisted search of 6 databases (CINAHL, Proquest, PsycInfo, PubMed, Cochrane, Web of Science) from inception to August 2024. Inclusion criteria were 1) reports of ICU diary implementation processes or reports of implementation outcomes, facilitators, or barriers; 2) original research, EBP, QI, practice descriptions, or dissertations; 3) adult patient populations in ICU settings; 4) English or Dutch language. An updated search was run on the same databases from August 2024 to June 2025 to ensure an inclusive sample. All records were imported into Covidence, where duplicates were removed and 5 team members screened for inclusion by abstract and full text based on the pre-defined criteria. Discrepancies between reviewers were solved by another reviewer. Data were extracted using the Consolidated Framework for Implementation Research (CFIR) and Proctor Outcomes for Implementation Research Framework to systematically capture implementation determinants and outcomes, respectively. We also identified specific implementation strategies using the Expert Recommendations for Implementing Change (ERIC) framework.


Results: The final sample (n= 49) represents studies published between 2003-2025 from 14 countries. We describe 1) reported ICU diary practices/strategies and implementation outcomes (e.g., acceptability, adoption, appropriateness, costs, feasibility, fidelity, penetration, and sustainability), 2) barriers and facilitators to successful implementation (e.g., uptake and use), and 3) critical research priorities to inform the development of evidence-based international guidelines for ICU diary program implementation and quality monitoring.


Conclusions: This work will establish the methodological foundation necessary for standardizing ICU diary practices to optimize their integration into critical care environments, and can be used to inform the development of guidelines for implementation of ICU diary programs.