OPERATIONAL AND DOCUMENTATION TOOLS USED BY REFERENT NURSES IN INTENSIVE CARE UNITS: A SCOPING REVIEW.

Survivorship after critical illness is increasing, but many intensive care unit (ICU) survivors experience persistent physical, cognitive, and psychological sequelae, commonly described as post-intensive care syndrome (PICS). Preventing and mitigating these outcomes depends not only on medical treatment, but also on consistent, high-quality nursing processes such as sedation and delirium assessment, early mobilization, symptom control, family engagement, and adherence to ICU care bundles. In this context, the Primary Nursing model (and equivalent role-based approaches such as named nurse/continuity nurse) may strengthen continuity, accountability, and individualized care planning. However, the operational and documentation tools that enable primary nurses to implement interventions, monitor nursing-sensitive outcomes (NSO), and sustain bundle adherence in adult ICUs have not been mapped systematically. This project is a scoping review designed to identify and describe the full range of operational and documentation tools used by primary nurses (or equivalent figures) in adult intensive care settings. Conceptually, the review is informed by Donabedian’s structure–process–outcome framework and Doran’s nursing-sensitive outcomes perspective to examine how organizational models and nursing processes may influence patient, family, and system outcomes. We will conduct the scoping review in accordance with the Joanna Briggs Institute (JBI) methodology for scoping reviews and will report findings following PRISMA-ScR. The Population–Concept–Context (PCC) elements are: (P) adult ICU patients and/or nursing teams delivering adult ICU care; (C) operational and documentation tools (e.g., checklists, flowsheets, templates, care plans, EHR-based tools, audit instruments, bundle tracking tools, NSO measurement tools); (C) adult intensive/critical care settings. We will search PubMed/MEDLINE, Scopus, CINAHL (EBSCO), and Web of Science Core Collection from 2000 to present (limits adjustable), using database-specific strategies combining controlled vocabulary and free-text terms. Two reviewers will independently screen titles/abstracts and full texts, with disagreements resolved through discussion (or a third reviewer if needed). Data will be charted using a standardized extraction form and synthesized descriptively by mapping tools to their purpose (intervention support, NSO monitoring, bundle adherence), format (paper vs electronic), implementation context, and reported impacts on nursing processes and outcomes. The review will produce a practical taxonomy of tools, identify evidence gaps, and inform future development or adaptation of nursing documentation systems and workflow supports for primary nursing in adult ICUs. Findings will be disseminated through publication and conference presentations, with materials shared openly where feasible.