Neglected ocular surface care in critical care medicine: An observational study

Selvan, Harathy; Pujari, Amar; Sachan, Anusha; Gupta, Viney; Sharma, Namrata

doi:10.1016/j.clae.2019.08.009

Cited by 12 publications

(22 citation statements)

References 10 publications

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“…1 The independent variables were selected from the NANDA-I Taxonomy and from others cohort studies on corneal injury in critically ill adults. 1,5,13,14 The independent exposure variables contained in the NANDA-I were eyeball exposure; prolonged hospitalization (more than 7 days); use of pharmaceutical agents (sedatives and vasoactive drugs); tracheostomy; periorbital oedema; GCS score < 6; orotracheal intubation; oxygen therapy; blinking <5 times per minute; and mechanical ventilation. 1 The other exposure independent variables were lagophthalmos and chemosis.…”

Section: Variablesmentioning

confidence: 99%

“…1 The other exposure independent variables were lagophthalmos and chemosis. 5,13,14 The non-exposure independent variables found in the literature were: age (continuous and categorical, < and ≥60 years of age); sex (female and male); type of hospitalization (clinical or surgical); type of corneal injury (keratitis or ulcer); and grade of corneal injury (I-IV, Grade I being the mildest and grade IV the most severe). 5,13,14…”

Section: Variablesmentioning

confidence: 99%

“…A data collection tool was constructed containing the dependent and independent variables. 1,5,13,14 On the first day, the patient was evaluated for independent and dependent variables by a critical care nurse. To have this diagnosis, patients needed to present three or more exposure risk factors.…”

Section: Data Collection Form and Proceduresmentioning

confidence: 99%

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Causal validation of the risk for corneal injury in critically ill adults

Pinheiro

Silva

Gimenes

et al. 2022

Nursing in Critical Care

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BackgroundThe validity of a nursing diagnosis depends on a continuous investigation process in different populations to provide clinical evidence. The risk for corneal injury nursing diagnosis was approved in 2013 and only reviewed in 2017, demonstrating the need to perform a clinical validation to improve it.AimTo perform a causal validation of the risk for corneal injury nursing diagnosis in critically ill adults.Study designA prospective cohort study was performed in two intensive critical care units in Northern Brazil with adults aged over 18 years without corneal injury at admission. The patients were evaluated for 10 days, using a data collection tool composed of risk factors for the risk for corneal injury nursing diagnosis. The independent variables were described through absolute and relative frequency. The accuracy measures and risk factors were identified through Cox regression, considering a 95% confidence interval.ResultsThe nurses assessed 209 critically ill adults and identified that 76.0% of them presented the risk for corneal injury nursing diagnosis, with 16.3% developing a corneal injury, all having previously presented the risk for corneal injury nursing diagnosis. The risk factors identified were eyeball exposure (hazard ratio: 1.78; 95% CI: 1.27–2.51), Glasgow score < 6 (hazard ratio: 1.73; 95% CI: 1.15–2.60) and periorbital oedema (hazard ratio: 1.43; 95% CI: 1.03–1.99), with these factors showing high specificity, and the mechanical ventilation variable, showing high sensitivity, with ROC curve of .86.ConclusionEyeball exposure, Glasgow score < 6 and periorbital oedema are the risk factors of the risk for corneal injury nursing diagnosis, in critically ill adults. These risk factors guide nursing interventions. This causal validation can improve the risk for corneal injury nursing diagnosis levels of evidence in the NANDA International Taxonomy.Relevance to clinical practiceIt is necessary to guide nursing interventions for critically ill adults with lowered level of consciousness and corneal exposure for the prevention of corneal injury.

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Section: Variablesmentioning

confidence: 99%

Section: Variablesmentioning

confidence: 99%

See 1 more Smart Citation

Causal validation of the risk for corneal injury in critically ill adults

Pinheiro

Silva

Gimenes

et al. 2022

Nursing in Critical Care

View full text Add to dashboard Cite

show abstract

“…Research suggests that even prior to COVID-19, eye care was neglected (Cho et al, 2017;Hearne et al, 2018;Selvan et al, 2020), with nurses focusing more on managing patient instability and organ failure (Silva et al, 2021). Before COVID-19, the frequency of corneal injury varied, with some reporting up to 42% of patients developing signs of corneal injury whilst others reporting between 23 and 60% (Hearne et al, 2018).…”

Section: Editorialmentioning

confidence: 99%

Optimising COVID-19 survivorship after ICU – Don’t forget eye care

Pirret

2021

Intensive and Critical Care Nursing

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“…During hospitalization, the medical staff mainly focuses on securing basic vital functions, controlling life-threatening disorders, and stabilizing the patient's condition. Less pressing problems, including ocular complications, are sometimes overlooked by medical professionals [1,2].…”

Section: Introductionmentioning

confidence: 99%

Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

Płaszewska‐Żywko

Sega

Bukowa

et al. 2021

IJERPH

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In critically ill patients, normal eye protection mechanisms, such as tear production, blinking, and keeping the eye closed, are impaired. In addition, many other factors related to patients’ severe condition and treatment contribute to ocular surface disease. Reducing risk factors and proper eye care can have a significant impact on incidences of eye complications and patient quality of life after discharge from the intensive care unit (ICU). The aim of the study was to determine risk factors for ocular complication, especially those related to nursing care. The study was conducted in the ICU of a university hospital. Methods for estimating and analyzing medical records were used. The patient’s evaluation sheet covering 12 categories of risk factors for eye complications was worked out. The study group included 76 patients (34 patients with injuries and 42 without injuries). The Shapiro–Wilk test, the Spearman’s rank correlation test, the Mann–Whitney U test and the Friedman’s ANOVA test were used. The level of significance was set at α = 0.05. The most important risk factors for eye complications in the study group were: lagophthalmos (p < 0.001), sedation (p < 0.01), use of some cardiological drugs and antibiotics (p < 0.01), mechanical ventilation (p < 0.05), use of an open suctioning system (p < 0.01), presence of injuries (p < 0.01) including craniofacial trauma (p < 0.001), high level of care intensity (p < 0.01), failure to follow eye care protocol (p < 0.001), length of hospitalization at the ICU (p < 0.001), and the frequency of ophthalmological consultations (p < 0.001). There was no correlation between the incidence of these complications and the age and gender of the patients. The exposure of critically ill patients to eye complications was high. It is necessary to disseminate protocols and guidelines for eye care in ICU patients to reduce the risk factors.

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Neglected ocular surface care in critical care medicine: An observational study

Cited by 12 publications

References 10 publications

Causal validation of the risk for corneal injury in critically ill adults

Causal validation of the risk for corneal injury in critically ill adults

Optimising COVID-19 survivorship after ICU – Don’t forget eye care

Risk Factors of Eye Complications in Patients Treated in the Intensive Care Unit

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