EYECARE FOR THE SEDATED PATIENT UNDERGOING MECHANICAL VENTILATION - THE USE OF EVIDENCE-BASED CARE

There is a need to evaluate different nursing procedures to determine whether in today's cost-conscious climate of health care: they genuine ly benefit the patient. IF such procedures are indeed found to be of v alue, ways must be explored of ensuring that the manner in which they are performed conforms to acceptable standards. In the study reported here eyecare for the ventilated, sedated patient was examined because variations in clinical practice had been observed and a preliminary ex amination of the literature indicated that this patient group was at p articular risks of developing serious ocular complications. The study was conducted in two phases. Phase 1 took the form of a literature rev iew which demonstrated that although many questions remained unanswere d, sufficient information relating to eyecare existed to help develop protocols to guide care. Phase 2 consisted of non-participant observat ion with 15 nurses employed in an intensive care unit to examine the s tandard of eyecare actually delivered. The standard of eyecare fell sh ort of the ideal and as in other studies designed to observe nursing p rocedures accurately and in detail. there was no demonstrable relation ship between clinical practice, knowledge or clinical experience. From the study overall it was possible to conclude that patients would ben efit from the implementation and audit of guidelines for eyecare bur t hat before these innovations are undertaken barriers to good practice should be explored in intensive care units. (C) 1998 Elsevier Science Ltd. All rights reserved.