Wednesday, July 11, 2007
This presentation is part of : Acute Care Strategies
Implementing evidence-based practice in eye care for critically ill patients
Bernard M. Yam, MA, RN, Faculty of Nursing, Midwifery and Health, University of Technology, Sydney, New South Wales, Australia
Learning Objective #1: identify clinical nursing practice situations for quality improvement
Learning Objective #2: develop strategies in implementing evidence-based practice guidelines in clinical settings

Eye care is a basic nursing care procedure that can easily be overlooked when critically ill patients are admitted to the hospital. While their vital systems are the focus of attention, these patients are more at risk in developing eye complications due to impaired or compromised natural protective mechanisms. These complications may range from superficial corneal abrasions to serious permanent corneal damage that can have devastating effects on the quality of life of patients. Without proper attention complications can occur within a relatively short period, ranging from 48 hours to a week. The impetus for this study came from the diverse opinions among nurses caring for a patient who developed eye complications while being treated in the intensive care unit. This paper reports the experience of developing an eye care protocol for critically ill patients. A workgroup of nurses headed by the ward manager was established with a mandate to evaluate existing nursing practices. Results showed a weak link between theory and practice on eye care. A broad range of eye care procedures largely based on tradition or nurses’ individual beliefs and preferences was practised. Based upon a systematic review of the literature conducted by the Joanna Briggs Institute in Australia, an eye care protocol was developed. In-service educational sessions and various strategies promoting its use were launched before the pilot study. The final protocol was trialed in 20 patients over a one-month period. Results indicated that the protocol achieved the objective of standardizing clinical nursing practice without jeopardizing the quality of patient care. Nurses welcomed the change and applauded the ease of following the protocol. Improved collegial working relationship was also reported. This study clearly demonstrates the importance of effective leadership and teamwork in developing a protocol that benefits both patients and nurses.