Nursing interventions to prevent corneal injury in critically ill sedated and mechanically ventilated patients: A systematic review of interventions.

OBJECTIVE: To identify the effectiveness of interventions to prevent corneal injury in critically ill, sedated, and mechanically ventilated patients. RESEARCH METHODOLOGY: A systematic review of intervention studies was conducted in the following electronic databases: Cumulative Index to Nursing and Allied Health Literature, Cochrane Central Register of Controlled Trials, Embase, Latin American and Caribbean Literature in Health Sciences, LIVIVO, PubMed, Scopus and Web of Science, and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Study selection and data extraction were performed by two independent reviewers. Quality assessment of the randomized and non-randomized studies was performed using the Risk of Bias (RoB 2.0) and ROBINS-I Cochrane tools, respectively, and the Newcastle-Ottawa Scale for cohort studies. The certainty of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. RESULTS: 15 studies were included. Meta-analysis showed that the risk of corneal injury in the lubricants group was 66% lower (RR = 0.34; 95 %CI: 0.13-0.92) than in the eye-taping group. The risk of corneal injury in the polyethylene chamber was 68% lower than in the eye ointment group (RR = 0.32; 95 %CI 0.07-1.44). The risk of bias was low in most of the studies included and the certainty of the evidence was evaluated. CONCLUSIONS: The most effective interventions to prevent corneal injury in critically ill sedated mechanically ventilated, who have compromised blinking and eyelid closing mechanisms, are ocular lubrication, preferably gel or ointment, and protection of the corneas with a polyethylene chamber. IMPLICATIONS FOR CLINICAL PRACTICE: Critically ill, sedated, and mechanically ventilated patients who have compromised blinking and eyelid closing mechanisms must receive interventions to prevent corneal injury. Ocular lubrication, preferably gel or ointment, and protection of the corneas with a polyethylene chamber were the most effective interventions to prevent corneal injury in critically ill, sedated, and mechanically ventilated patients. A polyethylene chamber must be made commercially available for critically ill, sedated, and mechanically ventilated patients.

Perceptions of digital technology in nursing education: A qualitative study.

AIM: The aim of this study was to explore how digital technologies can facilitate interactive learning in a 15-credit theory module on basic nursing. BACKGROUND: Digital platforms are in widespread use in nursing education; however, the rapid technological advancement provides new opportunities to support teaching and learning. This indicates the need to explore how educational digital technologies can be used as an integral part of learning activities to promote quality and relevance in nursing education. This study was carried out at the Department of Nursing Science at a university in Norway. The university has been using a digital platform for many years and has recently adopted a new platform named Canvas in 2018. DESIGN: An explorative qualitative research design using focus group interviews. METHODS: Three focus group interviews were conducted with students and teachers involved in a 15-credit module in basic nursing as part of the first year of the bachelor program. A total of 10 participants were recruited for this study and data were analysed using systematic text condensation. RESULTS: The analysis resulted in three themes related to experiences with existing learning activities and general perceptions of digital technologies: 'pedagogical methodology affects learning and social fellowship'; 'need for varied, high-quality forms of learning' and 'need for structure and predictability'. CONCLUSION: This study revealed several educational needs and emphasised the importance of digital competence involving professional knowledge and skills to facilitate the educational use of digital technologies.

Participants' perceptions of an intervention implemented in an Action Research Nursing Documentation Project.

AIMS AND OBJECTIVES: The aim of this study is to describe healthcare professionals' experiences and perceptions of an intervention implemented in an action research project conducted to improve nursing documentation practices in four municipalities in Norway. BACKGROUND: Documentation of individualized patient care is a continuing concern in healthcare services and could impacts the quality and safety of healthcare. Use of electronic systems has made some aspects of documentation more comprehensive, but creation of an individualized care plan remains a pressing issue. DESIGN: A qualitative descriptive design was used. METHODS: An action research project was conducted between 2010-2012 to improve the content and quality of nursing documentation in community healthcare services in four municipalities. One year after the project was completed four focus group interviews were conducted with healthcare professionals, one for each involved municipality. Two unit managers were interviewed individually. Qualitative content analysis was used. RESULTS: Three themes emerged: healthcare professionals perceived competing interest; they experienced that they had to manage complexity and changes; and they highlighted a clear and visible leader as important for success. CONCLUSIONS: Quality improvement activities are essential. Healthcare professionals experience a complicated situation when electronic health record systems do not support workflow. Further research is recommended to focus on the functionality and user interface of electronic health record systems, and on the role of leadership when implementing changes in clinical practice. RELEVANCE TO CLINICAL PRACTICE: Stronger cooperation among policymakers, electronic health record system vendors, and healthcare professionals is essential for improving electronic health record systems and documentation practices. Involvement of end-users in these improvements can make a difference in the way the systems are perceived in the clinical workflow.

Nursing Documentation: An Evaluation of an Action Research Project.

This abstract describes an evaluation of an action research project conducted to improve nursing documentation practice in four municipalities in Norway. In an explorative design, four focus group interviews and two individual interviews were conducted. The interview data were analyzed using content analysis. Three themes emerged: healthcare professionals perceived the documentation process as complicated; they experienced competing interests; and they highlighted a clear and visible leader as important for success. This study provides knowledge about the importance of collaboration and involvement of stakeholders when developing electronic health record systems.