[Current status of nutritional care provision to burnt patients: processes audit of a burnt patients department from a tertiary hospital].
BACKGROUND
Response of the burned patient to surgical medical treatment might depend not only upon the damages brought about by thermal aggression, namely, increased metabolic requirements, onset of the Systemic Inflamatory Response Syndrome, and microbial infections, but also the cultural practices embedded within nutritional care institutional processes.


OBJECTIVE
To assess how conduction of nutritional care processes of assessment and intervention may influence therapeutical effectiveness indicators of hospital Burn Services. STUDY SERIES: Forty-two patients with a Burn Body Surface Area (BBSA)>10% assisted at the Burn Service of the "Hermanos Ameijeiras" Clinical Surgical Hospital (La Habana, Cuba), between January 2001-December 2003.


METHODS
Nutritional care of assessment and intervention conducted upon the burn patient were audited after reviewing clinical charts. The audited processes were declared as Completed (or not). Completeness of the process was related to complications and mortality rates, and length of hospital stay predicted from BBSA.


RESULTS
Nutritional care processes of assessment and intervention were completed in 49.4% and 22.6% of the audited charts, respectively. Prospective recording of patient's body weight was associated with lower mortality. Early nutritional assessment and sufficient energy supply to patients with BBSA>20% were associated with lower complications rates and better compliance with BBSA-predicted length of stay.


CONCLUSIONS
This work is the first enquiry into the behaviour of the institution's Burn Service, in anticipation of the design and implementation of a medical care Continuous Quality Improvement Program. In spite of the current state of nutritional care processes completeness, their observance might favorably influence the Service's effectiveness indicators.
Miquet Romero
L M
LM
Servicio de Quemados, Hospital Clínico Quirúrgico Hermanos Ameijeiras, La Habana, Cuba. lmmiquet@infomed.sld.cu
Rodríguez Garcell
R
R
Barreto Penié
J
J
Santana Porbén
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002056:Burns / Q000628:therapy*; D005260:Female; D006748:Hospital Departments; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D018529:Nutritional Support