[Quality of care in intensive care units. Retrospective study on long-term patients]

Nursing care must be evaluated in order to determine its effectiveness and identify deficiencies, which makes it possible to introduce corrective measures to optimize quality. The quality of care given to patients in our unit was evaluated with a retrospective analysis of 915 records in the Nursing Care Plan corresponding to 59 patients with a mean ICU stay of 15.5 days. Six areas of care and indicators of deficient practice were identified: orotracheal intubation: accidental disconnection, displacement, obstruction, and pressure sores on lips; arterial catheterization: accidental disconnection and obstruction; central venous catheterization: accidental disconnection and contamination; urinary catheterization: accidental disconnection and urinary bacteriology; nasogastric intubation: accidental disconnection, obstruction, and nasal pressure sores; conservation of skin integrity: presence of pressure sores, and prevention of falls from the bed or chair. The reference standards were taken from the published literature. The results show that airway care was adequate, although the frequency of pressure sores on the lip produced by orotracheal tubes was high. The indicators for following up the care of vascular and urinary catheters showed results similar to established standards. There was a high rate of nasogastric tube obstruction due to the administration of medication. Finally, the frequency of pressure sores was well below established standards and there were no accidental falls. It is concluded that the detection of areas in which care is deficient requires an analysis of relevant nursing activities so that corrective measures can be taken. This study is a useful baseline for future quality control.