[Care plan versus care protocol. Comparative analysis in patients subjected to cardiac catheterism]. / Plan de cuidados frente a protocolo asistencial. Análisis comparativo en pacientes sometidos a cateterismo cardíaco.

The nursing product marks the present and future of the nursing staff. The tools used in the nursing staff should be complete and favor their work. The importance of the cares, during the stay of the patients in the intensive care units, is justified by the obtaining of results and some levels of quality that are adequate for the health care setting. The project aims to know the efficacy of the registered nursing care procedure, care plan or care protocol in an intensive care unit, with a system of computerized clinical records. The resulting information shows a value for the time dedicated to work with the plan greater than that used with the protocol (p = 0.01). In turn, the quality indicators used in both systems are graded as acceptable, although they obtain better results in the care plan. The nursing staff that participate in the study consider that the utility of the care plan in the unit is limited or null for 42.9% and 21.4%, respectively. It should be remembered that the work system in forced in the unit for the nursing care is a care protocol In conclusion, we state that the care plan has better quality in the records than the care protocol, while it requires greater time to fill out the nursing records.

Plan de cuidados frente a protocolo asistencial. Análisis comparativo en pacientes sometidos a cateterismo cardíaco / Care plan versus care protocol. Comparative analysis in patients subjected to cardiac catheterism

El producto enfermero marca la actualidad y futuro de la enfermería. Las herramientas que emplea la enfermería deben ser completas y favorecer su trabajo. La importancia de los cuidados, durante la estancia del paciente en las unidades de cuidados intensivos, se justifica mediante la obtención de unos resultados y de unos niveles de calidad adecuados a su entorno sanitario. El proyecto tiene como objetivo conocer cuál es la eficacia del procedimiento asistencial de enfermería registrado, plan de cuidados o protocolo asistencial, en una unidad de cuidados intensivos, con un sistema de registro clínico informatizado. La información resultante muestra un valor para el tiempo destinado al trabajo con el plan superior al empleado con el protocolo (p = 0,01). A la vez, los indicadores de calidad utilizados en ambos sistemas se califican como aceptables, aunque obtienen mejores resultados en el plan de cuidados. La enfermería que participa en el estudio, opina que la utilidad del plan de cuidados en la unidad es escasa o nula para el 42,9 y el 21,4%, respectivamente. Conviene recordar, que el sistema de trabajo vigente en la unidad para la asistencia de enfermería, es el protocolo asistencial. En conclusión, el plan de cuidados presenta mejor calidad en los registros que el protocolo asistencial, a la vez que requiere una mayor inversión de tiempo para cumplimentar los registros de enfermería

The nursing product marks the present and future of the nursing staff. The tools used in the nursing staff should be complete and favor their work. The importance of the cares, during the stay of the patients in the intensive care units, is justified by the obtaining of results and some levels of quality that are adequate for the health care setting. The project aims to know the efficacy of the registered nursing care procedure, care plan or care protocol in an intensive care unit, with a system of computerized clinical records. The resulting information shows a value for the time dedicated to work with the plan greater than that used with the protocol (p = 0.01). In turn, the quality indicators used in both systems are graded as acceptable, although they obtain better results in the care plan. The nursing staff that participate in the study consider that the utility of the care plan in the unit is limited or null for 42.9% and 21.4%, respectively. It should be remembered that the work system in forced in the unit for the nursing care is a care protocol In conclusion, we state that the care plan has better quality in the records than the care protocol, while it requires greater time to fill out the nursing records

[Repercussion on the hemodynamic measurements across a Swan-Ganz catheter with the postural changes]. / Repercusión en las mediciones hemodinámicas a través de un Swan-Ganz con los cambios posturales.

AIM: Usually hemodynamic measures are done with the patient in dorsal decubitus and the bedside at 0 degrees. Our aim has been to evaluate the influence that postural changes has in the hemodynamic measures which were carried out with a pulmonary artery catheter, so as called Swan-Ganz. MATERIAL AND METHOD: It's a prospective study. The same patient is control group and study group. There were done tree consecutive measures in each patient. Firstly in dorsal decubitus, then right lateral decubitus and finally in left lateral decubitus. Before doing the measures after change of posture a thirty minutes period was left in order to stabilise the hemodynamical flow. The items of study were, a part of demographic ones, cardiac index, pulmonary artery systolic pressure, pulmonary artery diastolic pressure, pulmonary artery mean pressure, pulmonary artery occlusion pressure, right atrial pressure, systolic arterial pressure, diastolic arterial pressure, mean arterial pressure and heart rate. 28 patients were included in the study. RESULTS: The age average was 62.5 years (27.05-67.05); a 78.6% were male. Who had a NEMS average of 42.4 (39.9-44.9). No difference was found between hemodynamic measures in the different postures. CONCLUSIONS: Postural changes in stable patients have no influence in pressures and other hemodynamic variables measures.