Evaluation of the nurse care given to critically ill patients through quality indicators

Objective

To improve nurse care given to patients in the ICU through the systematic collection of data from six previously defined quality indicators.

Methods

Retrospective analysis of six quality indicators (phlebitis, falls out of the bed, accidental extubation, drug-related complications, pressure ulcer and accidental nasoenteral catheter displacement) from a 10-bed medical ICU in a private hospital, which were collected daily by nurses from the data found in the patient's medical register. A monthly critical and statistic evaluation of these data was accomplished in order to develop an action plan.

Results

According to the goal established by the institution, some indicators such as phlebitis and fall out of the bed were found within the expected rates. The accidental extubation and development of pressure ulcers were very close to the expected numbers. According to Souza and colleagues [1] the daily evaluation and systematic intervention in order to prevent and treat pressure ulcers is a nurse's task. There is a proven relation between assistance quality and pressure ulcer care. The drug-related complications and nasoenteral catheter displacement were above the established limits, requiring specific actions from the ICU team to reduce these problems.

Conclusion

The rates presented through the analyses of the quality indicators shows specific failures in nurse care. The action plan to correct these failures consists of continued education with close monitoring of the quality indicators to assure better results, regarding increased patient safety.