Nurses can play an active role in the early diagnosis of exposure keratopathy in intensive care patients

Abstract

Aim: This study was conducted in order to determine nurses' ability to diagnose exposure keratopathy reliably in the early stage in intensive care patients. Methods: This methodological and descriptive study was carried out between 2011 and 2012 in the Neurology and Anesthesiology and Reanimation Intensive Care Units of a teaching hospital in western Turkey. The sample consisted of 4354 ocular assessments in 156 corneas of 78 patients. A patient identification form and a fluorescein test patient tracking chart were used in the data collection. The corneas of the patients were checked by a fluorescein dye test by the same nurse and ophthalmologist. Results: The mean age of the patients was 59 AE 15.5 years and 47.4% of them were female. The consistency between the nurse and the ophthalmologist was almost perfect in terms of determining the presence of exposure keratopathy, characteristics, and the grade of corneal staining. Exposure keratopathy was detected at a rate of 2% by the ophthalmologist. A significant relationship was found between the presence of lagophthalmos and the development of exposure keratopathy. A positive correlation was found between the grade of corneal staining and the degree of the eyelid position of the patients and the duration of mechanical ventilation therapy. Conclusion: After eye care and assessment training, intensive care nurses can play an effective role in detecting early-stage exposure keratopathy in intensive care patients.

Knowledge and practice patterns of Intensive Care Unit nurses towards eye care in Chhattisgarh state

“…However, nurses, when trained adequately, can screen for ocular complications and triage so that only those who need special ophthalmic care are referred to the ophthalmologists. [ 3 15 ]…”

Effect of polyethylene cover on the treatment of exposure keratopathy in ICU

“…1,[5][6][7] The rate of EK in ICU patients under MV was reported in previous studies to be between 2% and 57%. 3,[8][9][10] In an earlier phase of this study, the rate of EK was found to be 2%. 8 EK may lead to serious complications such as microbial keratitis and visual impairment if not treated.…”

“…8,10 In an earlier phase of this study, we found that, after training, ICU nurses can perform the fluorescein test and detect corneal damage in the early stage. 8 Eye toileting, lubrication, adhesive tape, passively closing the lids, polyacrylamide hydrogel dressings (Geliperm), and moisture chambers (swimming goggles or polyethylene covers [PC]) have been studied with the aim of preventing and treating EK and other ocular surface disorders. [11][12][13][14] Taping the eyelids may lead to skin damage and be seen as unsightly by the patient's relatives.…”

Eye Problems, Eye Care and Ocular Awareness in Stage 3 Intensive Care Unit

“…At this point, the basic deficiency was in the lack of application rather than the lack of knowledge (2,16,17). In the studies that have been conducted, training was given to the healthcare personnel working with the patients, and significant decreases were observed in the emergence of ocular diseases after this training (18,19). Kousha et al (16) observed that the keratopathy exposure rate decreased from 21% to 2.6% after a simple maintenance protocol application, and they pointed out the importance of implementing a simple and standardized protocol, as did other researchers.…”