[Study for the decrease of errors in the records of hydric balances of critical patients admitted to an intensive care unit].

Abstract

OBJECTIVES: Due to the results of the hydric balances, we believed that it did not adjust to the weight variations of the patients, that we should assure ourselves that the present recording method was a good reflection of the hydric changes of the patients and based on the diagnoses, interventions and results, the nurses of NANDA (North American Nursing Diagnosis Association), NIC (Nursing Interventions Classification) and NOC (Nursing Outcomes Classification) have suggested studying the errors in the records and how to reduce them without increasing work loads. MATERIAL AND METHODS: Descriptive comparative study divided into two stages: a first one in which, on the one hand, we study the validity of our measurement systems by means of contingency tables, measurements of central tendency and dispersion, correlation (Pearson) and concordance (Bland-Altman (BA) and, on the other hand, we detect arithmetic errors in the records, and a second stage in which we analyze, by means of the Student's t test, the existence or not of significant differences between records without correction (WC), arithmetically corrected (AC) and arithmetically corrects and in measurement errors (ME) in all the patients admitted for 5 days (mean stay time) in our ICU. Confidence interval level was 95%. RESULTS: We found significant variations in the real serum volume (+10%). We accept that perfusion pumps, graduated cups Coloplast bags, diuresis cage and weighing of absorbent material are great measurement systems. For this, r > 0.9979 and good differences of the means and confidence interval in the Bland-Altman analysis were found. We ruled out the subject assessment of volumes (large relative errors) and the diuresis bottles (r = 0.6986 and in mean BA of 21.593 cm3 and large dispersion of the differences). For the Uroway bags, we established a correlation curve (y = 4.0117x0.8292). We detected 64.0% (on 75 records) with arithmetic errors. In the Student's t analysis, we obtained: WC/AC, p = 0.654; AC/ME, p < 0.001; WC/ME p = 0.016 (significance level = 0.05). CONCLUSIONS: We verified the existence of significant differences between the ME and the WC and AC.