Care and clinical indicators in intensive care: an integrative literature review on quality management

Abstract

Introduction: Intensive Care Units (ICUs) are highly complex environments in which the quality of care depends on the continuous monitoring of clinical and healthcare indicators related to patient safety and health outcomes. Objective: To analyze the scientific evidence regarding the main clinical and healthcare indicators used in quality management in ICUs. Method: This is an integrative literature review conducted according to the stages proposed by Whittemore and Knafl. The search was performed in the Biblioteca Virtual em Saúde (BVS) and PubMed databases using descriptors related to intensive care, quality of care, and patient safety. Full-text articles published within the last five years, in Portuguese, English, and Spanish, were included. Data were analyzed descriptively and organized through thematic categorization. Results: A total of 17 studies were included and organized into four categories: infection and adverse event indicators; clinical performance indicators; care process indicators; and organizational factors related to quality of care. Continuous monitoring of indicators and implementation of care protocols contributed to the reduction of adverse events and improvement of clinical outcomes. However, weaknesses such as underreporting of events, failures in records, and organizational limitations negatively impacted the quality of care. Conclusion: Clinical and healthcare indicators are essential tools for quality management in ICUs, supporting the identification of failures, planning of interventions, and promotion of patient safety. Their effectiveness depends on adherence to evidence-based practices and the strengthening of a patient safety culture within healthcare institutions.