A bundle improves eye care in PICU
Karen McCall1, Hussin M Hussin2, Maria Elena Gregory3
1Department of Newborn Research, Murdoch Children's Research Institute, Melbourne, Australia.
Insights
Implementing an eye care bundle significantly improved eye care provision in a pediatric intensive care unit (PICU). This intervention reduced the incidence of corneal epithelial deficits in critically ill children.
Area of Science:
- Ophthalmology
- Pediatric Critical Care
Background:
- Critically ill children in pediatric intensive care units (PICUs) are at high risk for corneal epithelial deficits.
- Existing eye care practices in the studied PICU were insufficient to prevent these deficits.
Purpose of the Study:
- To assess the impact of a novel eye care bundle on the provision of eye care and the incidence of corneal epithelial deficits in a PICU population.
Main Methods:
- An eye care bundle was implemented, including a standardized guideline, electronic prescribing of eye lubricants, and staff education.
- Ophthalmic examinations were conducted weekly for two months post-implementation to evaluate eye care and corneal health.
Main Results:
- Formal eye care provision increased dramatically from 19% to 96%.
- The incidence of corneal epithelial deficits decreased post-intervention.
- Simple eye ointment proved effective in reducing deficits, even with incomplete eyelid closure.
Conclusions:
- An eye care bundle, supported by a multidisciplinary team, enhances eye care delivery in PICUs.
- This approach is effective in preventing corneal complications in critically ill pediatric patients.
Background:
Intensive care patients are susceptible to developing painful corneal epithelial deficits. Provision of eye care to prevent deficits was limited in our paediatric intensive care unit (PICU) population.
Interventions:
A new eye care bundle was introduced, comprising a guideline for eye care, the addition of eye lubricants to the electronic prescribing order set for new admissions to PICU and staff education on the importance of eye care. Weekly examinations over a 2-month period following implementation of the bundle evaluated eye care provision and presence of corneal epithelial deficits on ophthalmic examination.
Results:
Provision of formal eye care improved from 19% to 96%. The incidence of deficits was lower than previously, simple eye ointment reduced the risk of deficits, even in incompletely closed eyes.
Conclusions:
Use of an eye care bundle, together with a multidisciplinary team approach to eye care, improves the provision of eye care in PICU.
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