Authors (including presenting author) :
Ku S Y(1), Chan W K(1), Ip W S(1)
Affiliation :
(1) Department of Paediatrics & Adolescent Medicine, Princess Margaret Hospital, Kowloon West Cluster
Introduction :
Defense mechanisms of eye comprise eyelid closure and blinking of eyelid for distribution of tear film. Common contributing factors include impaired level of consciousness, reduced blink reflex, neurological lesions with sensory or motor loss and conjunctival oedema. The breakdown of the mechanism left cornea exposed and hence dried up. The risk of infection and scarring increase, which may even lead to poor vision or permanent visual loss.
Objectives :
(1) to develop a standard practice of eye care for nurses in PICU by using EBP approach;
(2) to Increase eye care-related knowledge and the level of practice among nurses in PICU in order to deliver & maintain consistent eye care;
(3) to early recognize & prevent corneal dryness among patients with impaired eye defense mechanisms.
Methodology :
Literature search was conducted on 25/8/2019 through Local & international guidelines, CINAHL, Cochrane Library, Joanna Briggs Institute EBP, PubMed, EMBASE, MEDLINE, Nursing Reference Centre Plus. Various types of studies such as Randomized Control Trial, meta-analysis and literature review were included to develop an evidence based standard practice for eye care for patients with impaired ocular defense mechanisms.
Result & Outcome :
Since June, 2020, the standard practice of eye care has been commenced in the PICU after provision of education talk to all PICU nurses. Eye care including the assessment, application of eye ointment and hypoallergenic tape for eyelid closure were practiced according to the workflow. From June to December, 2020, 86 patients were admitted to PICU. Compared with the situation before the introduction of the standard practice, all patients with impaired ocular defense mechanisms had eye ointment and eyelid taping applied, and patients with symptoms of corneal dryness decreased from 57% to 9%. (odd ratio= 1.96).
The standard practice of eye care was effective for early recognition and prevention of corneal dryness among patients with impaired eye defense mechanisms. All nurses in PICU have increased their eye care-related knowledge and were able to follow the workflow to perform eye assessment and to provide consistent eye care.
