Kocaçal Güler Elem, Eşer İsmet, Eğrilmez Sait
Department of Fundamentals of Nursing, Faculty of Nursing, Ege University, İzmir, Turkey.
Department of Ophthalmology, Ege University Medical Hospital, İzmir, Turkey.
Jpn J Nurs Sci. 2018 Jan;15(1):31-38. doi: 10.1111/jjns.12165. Epub 2017 Feb 7.
This study was conducted in order to determine nurses' ability to diagnose exposure keratopathy reliably in the early stage in intensive care patients.
This methodological and descriptive study was carried out between 2011 and 2012 in the Neurology and Anesthesiology and Reanimation Intensive Care Units of a teaching hospital in western Turkey. The sample consisted of 4354 ocular assessments in 156 corneas of 78 patients. A patient identification form and a fluorescein test patient tracking chart were used in the data collection. The corneas of the patients were checked by a fluorescein dye test by the same nurse and ophthalmologist.
The mean age of the patients was 59 ± 15.5 years and 47.4% of them were female. The consistency between the nurse and the ophthalmologist was almost perfect in terms of determining the presence of exposure keratopathy, characteristics, and the grade of corneal staining. Exposure keratopathy was detected at a rate of 2% by the ophthalmologist. A significant relationship was found between the presence of lagophthalmos and the development of exposure keratopathy. A positive correlation was found between the grade of corneal staining and the degree of the eyelid position of the patients and the duration of mechanical ventilation therapy.
After eye care and assessment training, intensive care nurses can play an effective role in detecting early-stage exposure keratopathy in intensive care patients.
开展本研究以确定护士在重症监护患者中早期可靠诊断暴露性角膜病变的能力。
本方法学描述性研究于2011年至2012年在土耳其西部一家教学医院的神经科、麻醉科及复苏重症监护病房进行。样本包括对78例患者156只角膜进行的4354次眼部评估。数据收集时使用了患者识别表和荧光素试验患者追踪图表。由同一名护士和眼科医生通过荧光素染色试验检查患者的角膜。
患者的平均年龄为59±15.5岁,其中47.4%为女性。在确定暴露性角膜病变的存在、特征及角膜染色分级方面,护士与眼科医生之间的一致性几乎完美。眼科医生检测到暴露性角膜病变的发生率为2%。发现兔眼的存在与暴露性角膜病变的发生之间存在显著关联。角膜染色分级与患者眼睑位置程度及机械通气治疗持续时间之间存在正相关。
经过眼部护理和评估培训后,重症监护护士可在检测重症监护患者的早期暴露性角膜病变方面发挥有效作用。