Critical care involves monitoring patients facing life-threatening conditions, requiring a multidisciplinary approach that includes early recognition, timely interventions, and follow-up care. Despite the focus on critical life-saving measures in the intensive care unit (ICU), early eye care is crucial for preventing ocular complications. This study evaluates ICU nurses’ knowledge, attitude, and practices (KAP) regarding eye care before and after a training program. Data showing specific questions and the pre- and post-test response analysis is shown in Table 1. The research was conducted in a tertiary hospital using a pre- and post-training questionnaire administered to ICU nurses. The nurses were trained in identifying ocular infections, proper eyelid closure, and techniques for applying ocular medications and eyelid taping.
Table 1.
Data showing specific questions and the pre- and post-test response analysis
| Group Variable | Percentage of pretest correct responses (actual response numbers) | Percentage of post-test correct responses (actual response numbers) | P | |||
|---|---|---|---|---|---|---|
| Is the position of the AC vent taken into consideration while allotting beds to the patients | 78.1 (153) | 92.3 (131) | <0.001 | |||
| Is eye care practiced as a part of the daily ICU care routine | 19.9 (39) | 69.7 (99) | <0.001 | |||
| What are the signs to look for in the eye in a patient admitted to the ICU | 82.7 (162) | 99.3 (141) | <0.001 | |||
| How to assess whether a patient’s eyes are dry | 16.4 (32) | 45.1 (64) | <0.001 | |||
| At what amount of adequate lid closure do you think Ophthalmology reference should be sought | 27.6 (54) | 94.4 (134) | <0.001 | |||
| What steps can you take to prevent eye redness/watering/dryness | 43.6 (85) | 99.3 (141) | <0.001 | |||
| How is eye-taping done | 0.5 (1) | 88.7 (126) | <0.001 |
A total of 196 ICU nurses participated in the study, with 141 attending the post-training session. The mean age of participants was 33 years, with the majority being female (79.6%). Before the training, 55% of nurses were familiar with signs of ocular infections, and only 30% knew how to assess dry eyes. Following the training, 72% of nurses were aware of proper eyelid closure techniques, 63% understood how to identify ocular infections, and the ability to assess dry eyes increased from 30% to 69%. The practice of eyelid taping correctly rose from 21% to 67%. The study highlights a critical gap in ICU eye care knowledge and practices, with only 21% of nurses demonstrating good practices prior to the training.
Previous studies by Güler EK et al.[1] suggested a lack of knowledge in eye care among critical care nurses. Alghamdi et al.[2] also reported poor knowledge which stated that 46.7% of ICU nurses had adequate knowledge of eye care, whereas 40% had poor knowledge. On the other hand, Khalil et al.[3] reported sound knowledge of nurses. It was a study conducted in ICUs at Talkha Central Hospital and Mansoura University Emergency Hospital with a sample size of 89. Vyas S et al.[4] quoted that 93% of nurses had prior knowledge about the increased risk of exposure keratopathy in ventilated patients. Only 21% of the participants had good practice, which was consistent with the findings of Lami et al.,[5] which suggested that 25.7% of the participants had good practice in providing eye care to ICU patients; 28.9% had poor practice, and 45.4% had fair practice in eye care. The findings were consistent with Fashafsheh et al.[1] and Khalil et al.[3] 59% felt eye care was due to lack of knowledge, whereas 19% felt eye care was not an important job, that is, had a negative attitude which was reinforced by Sayed et al.[6] The remaining proportion of nurses felt that there was a lack of time (12%) or too much documentation necessary (6%). Very few nurses felt care demands additional work (4%).
While ICU nurses often focus on life-threatening issues, proper eye care is also essential to prevent severe ocular damage, including blindness. A comprehensive eye care training program for ICU nurses improves both knowledge and practices, ultimately reducing complications and enhancing patient outcomes.
References
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