[Variability in working systems in intensive care units]

Patients attended in Intensive Medicine Services (IMS) require a high therapeutic support. To do so, each IMS elaborates a work system (monitoring of constants, insertion of catheters,...) aiming to respond to these high necessities of therapy. The objective of this study is to describe the variability among different IMS.

The study was performed in 15 hospitals in Catalonia between April and May 1995. In the end two of them did not participate in the study. In each hospital 180 pieces of data were collected referring to their material and human resources, graphics of data collection, monitoring of respiratory system (mechanical ventilator, aspirations of secretions, tracheostomy care), techniques of catheterization of artery and venous via vesical probing, prevention of pressure ulcers , hygiene of patients, nutrition, family treatment and data about medical orders and nursing courses. Similarly, the fact whether the work system was justified by studies from the same IMS, other centres, or whether it was simply unknown, was also evaluated.

There was a great variability among the IMS studied, oscillating significatively according to assigned resources, frequency of action and cost. According to the procedure 61% of IMS did not justify the work systems depending on scientific data.

it is necessary to unify the different work systems. To do so, and in our opinion, scientific societies should establish common norms, guidelines and protocols so as to obtain a higher efficiency of IMS.