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Published on: January 16, 2019
Eyecare in the critically ill: clinical practice guideline
Andrea P Marshall1, Rosalind Elliott, Kaye Rolls
1Critical Care Nursing, Faculty of Nursing and Midwifery (MO2), The University of Sydney, SYDNEY NSW 2006, Australia. amarshall@nursing.usyd.edu.au
Summary
This guideline provides recommendations for eyecare in intensive care units to prevent complications. Key actions include assessing risk factors, monitoring for issues, and ensuring eyelid closure for all patients.
Area of Science:
- Critical Care Medicine
- Ophthalmology
Background:
- The Intensive Care Collaborative project aimed to improve care in NSW Intensive Care Units.
- Eyecare guidelines for intensive care patients were developed to enhance clinical practice.
Purpose of the Study:
- To develop evidence-based recommendations for eyecare in intensive care settings.
- To improve the standard of care for intensive care patients regarding eye health.
Main Methods:
- Searched multiple bibliographic databases (PubMed, CINAHL, Medline, Cochrane Library) and Google Scholar.
- Included observational and interventional studies, with reviews by at least two Guideline Development Network members.
- Utilized a modified Delphi process for consensus on recommendations, assessing evidence against NHMRC levels.
Main Results:
- Recommended assessing patients for iatrogenic ophthalmologic complication risk factors and eyelid closure ability.
- Recommended monitoring complication rates and timely referral for suspected issues.
- Advised maintaining eyelid closure and providing hourly eye care for patients unable to achieve it independently.
Conclusions:
- Clinical practice guideline recommendations were peer-reviewed by ophthalmology experts.
- Despite reliance on limited, low-level evidence, recommendations can positively impact patient outcomes.
- Implementation encourages assessment, monitoring, and preventative interventions for ophthalmological complications.
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