[Evaluation of care quality in the ICU through a computerized nursing care plan]

The computerized systems that are being implemented for the recording of the Nursing Care Plan may facilitate the performance of continuing follow-up of the care quality. This retrospective descriptive study has been performed in a polyvalent Intensive Care Unit with the following objectives: a) describe the evaluation of the care quality, performed through the computerized record of the Nursing Care Plan; and 2) compare this evaluation with that performed in 1998, when the Nursing Care Plan had not yet been computerized. In the 98 revised computerized Nursing Care Plans, corresponding to the same number of patients with a mean stay of 13.8 days, the following results were obtained. Artificial airway. 74 patients had an endotracheal tube with a mean stay of 5.4 days, 11 patients had a cannula tracheotomy (time period of 45.7 days); no events occurred. Central venous lines: 91 patients were carriers of 163 catheters, the mean presence time was 9.9 days; three with withdrawn due to obstruction, there was one accident withdrawal and two were self-removed. Arterial catheter: the total number of arterial lines, corresponding to 87 patients, was 101 with a mean presence of 6.7 days; 15 obstructions, six accidental withdrawals and four self-removals were recorded. Bladder catheter: 91 patients had a bladder catheter (mean presence 12.9 days); no event occurred. Nasogastric tube: 83 patients were carriers of 98 tubes (63 Salem type and 35 for nutrition), with a mean presence of 10.1 days; five were withdrawn due to obstruction, three accidental withdrawals and 40 self-removed (23 in one patient). Skin integrity: nine patients developed bedsores, eight grade II and two grade III, the mean stay was 26.6 days. No patients had an accidental fall. As study conclusions, it stands out that the preestablished standards for the evaluation of the care were achieved in most and the care quality is maintained in relationship with our 1998 study, remaining within a level considered as good.