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The purpose of this research study was to determine the effectiveness of two nursing interventions in preventing dry eye in critically ill (ICU) patients. In determining which pharmaceutical approach to use, the authors compared two types of lubricating eye drops-liquid artificial tears (Lacribell), and artificial tears gel (Vidisic Gel) to help determine the most beneficial intervention for this group of patients (De Araujo et al., 2019).
The authors collected quantitative data on dry eye prevention. The study design involved the processing of data after two separate intervention plans. The researcher gathered the data with very little knowledge about the chosen intervention(s) this way, biased behavior can be prevented. The results were then analyzed to reflect the study’s intent of preventing dry eyes in adult patients in an Intensive Care Unit setting (De Araujo et al., 2019).
How it works
Following the inclusion and exclusion process, the resulted final sample ended in 140 participants. The number of included participants were then formed into two groups. Seventy receiving liquid artificial tears, and the other seventy receiving artificial tears gel. The conditions for inclusion in the study were, admission to the intensive care unit, age 18 or older, no dry-eye diagnosis at admission, recipient of mechanical ventilation, blink rate less than five times per minute, and a score of 7 or less on the Glasgow Coma Scale (De Araujo et al., 2019).
One researcher collected data on each individual included in the survey for five consecutive days. The same researcher also performed ocular assessments on all of the participants during this time. Five days were chosen due to the estimated dry eye development being three and a half days in critical patients. Before the ocular assessment, saline flushes were performed to keep the researcher from knowing the exact treatment used on each participant. This way, the researcher can provide blind results.
One of the data collection methods used was the Fluorescein eye stain test. This test was used to determine any defects in the cornea. The test was conducted by putting a drop of Fluorescein in each patient’s eyes, and by waiting for one to two minutes, under low light. The researcher was then able to use an ophthalmoscope, blue light filter, and magnifying glass to examine each cornea. The data was then collected and placed in the data collection instrument (De Araujo et al., 2019).
One of the data analysis tests used was the Fisher Exact test. I’ve learned, this test, as is true for all sample sizes, is a statistical significance test used in the analysis of categorical data. This test was used to analyze two interventional categories in this study (1) the incidence of dry eye (2) the effect of nursing interventions. Resulting in a 95% confidence interval (De Araujo et al., 2019).
The study had some limitations which could have affected the findings. One thing which stood out for me was the frequency of intervention. Every patient is unique and suffers from different health conditions. Not all patients require treatment at the same time of day. Maybe the findings and results would be different if these patients were being treated on an as-needed basis. If the patients were only receiving scheduled care, twice a day, instead of as needed, it may have caused a data collection and analysis mistake, impacting the results (De Araujo et al., 2019).
The researchers considered dry eyes to be a precursor to more serious eye damage, which can lead to a significant decline in a patient’s health. Through this, I discovered that that the quantity or consistency of tears can be the beginning of significant improvements in the ocular surface of the eyes, and that dry eye avoidance is necessary for patients with a critical illness. Nurses can help reduce the chance of ocular defects by recognizing patient risks and intervening accordingly (De Araujo et al., 2019).
As nurses, we depend on research results to make the right decisions while practicing. Research is important for the use of critical thinking skills. It helps us to have confidence during patient care while implementing the findings. The results of the research must remain current. Updated information allows nurses to provide the most effective nursing care for their patients. Continuing my education from an ADN to BSN and taking an EBP course allows me to appreciate research literature, encouraging me to make better use of it in practice.
My take-a-ways from this article is that ICU patients are at an increased risk for dry eye and that the system responsible for ocular lubrication and protection can become compromised in these patients. I also learned how important it is to consider dry-eye risk factors when a patient is admitted to an intensive care unit, and that the most effective medication is artificial tears gel (De Araujo et al., 2019).
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