Validez de contenido de la propuesta del diagnóstico de enfermería Sequedad ocular en pacientes adultos internados en la Unidad de Cuidados Intensivos / Content validity of the nursing diagnosis proposal Ocular dryness in adult patients admitted to the intensive care unit

Objetivo: Verificar la validez de contenido de la propuesta del diagnóstico de enfermería “Sequedad ocular” en pacientes adultos internados en una Unidad de Cuidados Intensivos. Materiales y métodos: Se trata de un estudio metodológico de validación de contenido de la propuesta del diagnóstico de enfermería “Sequedad ocular”, operacionalizado a través de un grupo focal. La selección de especialistas tuvo en cuenta la experiencia clínica y/o académica en el área de diagnósticos de enfermería y/o sequedad ocular y/o ojo seco y/o salud ocular, así como el tiempo de actuación con el tema. Fueron invitados 13 enfermeros que cumplieron con los criterios descritos anteriormente, de los cuales 10 aceptaron participar. El enfoque de validación fue por consenso. Los datos fueron analizados mediante estadística descriptiva, nivel de especialización y análisis de elementos diagnósticos. Resultados: Luego del consenso final de los jueces de enfermería en relación a los elementos diagnósticos, se definió una propuesta del diagnóstico “Sequedad ocular” basada en la validez de contenido con una nueva definición, 14 características definitorias, 9 factores relacionados, 2 poblaciones en riesgo y 20 problemas asociados. Además, luego de juzgar la coherencia de los elementos en relación a la estructura diagnóstica, los jueces emitieron el consenso en relación a las definiciones conceptuales y operativas (AU)

Objetivo: Verificar a validade de conteúdo da proposição diagnóstica de enfermagem Ressecamento ocular em pacientes adultos internados em Unidade de Terapia Intensiva. Materiais e métodos: Trata-se de um estudo metodológico de validação de conteúdo da proposição diagnóstica de enfermagem Ressecamento ocular, operacionalizado mediante grupo focal. A seleção dos especialistas levou em consideração a experiência clínica e/ou acadêmica na área de diagnósticos de enfermagem e/ou ressecamento ocular e/ou olho seco e/ou saúde ocular, bem como o tempo de atuação na temática. Foram convidados 13 enfermeiros que se enquadravam nos critérios acima descritos, dos quais 10 aceitaram participar. A abordagem de validação foi por consenso. Os dados foram analisados mediante estatística descritiva, nível de expertise e análise dos elementos diagnósticos. Resultados: Após o consenso final dos enfermeiros juízes em relação aos elementos diagnósticos, foi definida uma proposta do diagnóstico Ressecamento ocular a partir da validade de conteúdo com nova definição, 14 características definidoras, 9 fatores relacionados, 2 populações em risco e 20 condições associadas. Após julgar a coerência dos elementos em relação a estrutura diagnóstica, os juízes emitiram o consenso sobre as definições conceituais e operacionais. Conclusões: O estudo permitiu verificar a validade do conteúdo por juízes da proposição diagnóstica de enfermagem Ressecamento ocular em pacientes em unidades de terapia intensiva, o que favorece o raciocínio diagnóstico do enfermeiro e o planejamento de intervenções efetivas relacionadas a esse diagnóstico, permitindo o manejo do paciente de maneira a proporcionar a integridade ocular (AU)

Objective: to verify the content validity of the nursing diagnosis proposal Ocular dryness in adult patients admitted to an intensive care unit. Materials and methods: this is a methodological study of content validation of the nursing diagnosis proposal Ocular dryness, operationalized through a focus group. The selection of specialists took into account the clinical and/or academic experience in the area of nursing diagnoses and/or ocular dryness and/or dry eye and/or ocular health, as well as the time of performance with the theme. Thirteen nurses who met the criteria described above were invited, of whom 10 agreed to participate. The validation approach was by consensus. Data were analyzed using descriptive statistics, level of expertise and analysis of diagnostic elements. Results: after the final consensus of the nurse judges in relation to the diagnostic elements, a proposal of the diagnosis Ocular dryness was defined based on the validity of content with a new definition, 14 defining characteristics, 9 related factors, 2 populations at risk and 20 associated conditions. In addition, after judging the coherence of the elements in relation to the diagnostic structure, the judges issued the consensus in relation to the conceptual and operational definitions. Conclusions: the study allowed verifying the validity of the content by judges of the nursing diagnosis proposal Ocular dryness in patients in intensive care units, which favors the diagnostic reasoning of nurses and the planning of effective interventions related to this diagnosis, allowing the management of the patients in order to provide ocular integrity (AU)

Psychological and Ocular Surface State of Ophthalmologists and Ophthalmic Nurses Working With Patients With Coronavirus Disease 2019.

IMPORTANCE: The influence on the psychology and ocular surface of ophthalmologists and ophthalmic nurses in Wuhan, China, during the coronavirus disease 2019 (COVID-19) pandemic is not yet fully understood. OBJECTIVE: To characterize mental state and ocular surface state of ophthalmologists and ophthalmic nurses in Wuhan, China, and similar areas during the COVID-19 outbreak. DESIGN, SETTING, AND PARTICIPANTS: This survey study assessed ophthalmologists and ophthalmic nurses in Wuhan, China, and Jiangxi, China, a province approximately 300 km south of Wuhan. The Hospital Anxiety and Depression Scale, the Van Dream Anxiety Scale, and the Ocular Surface Disease Index were used to conduct questionnaire surveys via a messaging and social media app. MAIN OUTCOMES AND MEASURES: Mean scores from the Hospital Anxiety and Depression Scale (0-10 points), the Van Dream Anxiety Scale (0-100 points), and the Ocular Surface Disease Index (0-100 points). RESULTS: Of 126 individuals, there were 42 ophthalmologists (33.3%) and 21 ophthalmic nurses (16.7%) from Wuhan and 42 ophthalmologists (33.3%) and 21 nurses (16.7%) from Jiangxi. The mean (SD) age of ophthalmologists was 36.1 (7.6) years in Wuhan and 41.2 (8.8) years in Jiangxi. For ophthalmic nurses, the mean (SD) age was 35.2 (7.4) years in Wuhan and 33.4 (7.9) years in Jiangxi. The response rate for ophthalmologists was 90.3% (84 of 93) and for nurses was 91.3% (42 of 46). The participation rate of ophthalmologists and nurses in Wuhan was 0.06% (42 of 70 000) and 0.07% (21 of 30 000), respectively; the participation rate in Jiangxi was 0.06% (42 of 70 000; 21 of 35 000) for both groups. In Wuhan, the mean (SD) Hospital Anxiety and Depression Scale (anxiety and depression were counted as separate scores), Van Dream Anxiety Scale, and the Ocular Surface Disease Index scores were 6.90 (2.30), 7.38 (2.19), 24.52 (5.86), and 43.90 (3.74), respectively, in ophthalmologists and 8.67 (3.04), 9.38 (2.64), 21.48 (6.15), and 40.05 (6.67), respectively, in ophthalmic nurses. In Jiangxi, these scores were 5.67 (2.89), 4.90 (3.15), 12.76 (7.27), and 38.79 (7.78), respectively, in ophthalmologists and 4.67 (3.20), 4.33 (3.23), 10.10 (7.62), and 41.52 (5.92), respectively, in ophthalmic nurses. The difference (95% CI) between the 2 regions for these scores in ophthalmologists was 2.48 (95% CI, 1.30-3.65), 11.76 (95% CI, 8.90-14.63), 5.12 (95% CI, 2.45-7.79), and 5.12 (95% CI, 2.47-7.77), respectively, and in ophthalmic nurses was 4.16 (95% CI, 2.05-5.95), 5.05 (95% CI, 3.21-6.89), 11.38 (95% CI, 7.06-15.70), and -1.48 (95% CI, -5.41 to 2.25), respectively. CONCLUSIONS AND RELEVANCE: These findings suggest that ophthalmologists and ophthalmic nurses in Wuhan experienced more anxiety and depression and reported greater ocular surface abnormalities than counterparts outside of Wuhan, but the wide CIs preclude concluding confidently that there were differences.

Knowledge and practice patterns of Intensive Care Unit nurses towards eye care in Chhattisgarh state.

Purpose: The aim of the study was to present the level of knowledge and practice patterns regarding exposure keratopathy in mechanically ventilated patients among Intensive Care Unit (ICU) nurses in Chhattisgarh state. Methods: A previously validated semi-structured questionnaire was administered in the ICU of six multispecialty hospitals in Chhattisgarh in 2014-2015. Demography included age, gender, level of education, and months of working in ICU. Most of the questions dealt with frequency of eyelid closure assessment, frequency of cleaning of eyes with saline gauze, using a protocol-based approach for eye care, and documentation of ophthalmic complications. Common barriers to delivery of eye care such as shortage of time and too much writing tasks were also inquired. Results: Our study included 120 nurses. They worked for mean 22.9 ± 17.8 months in ICU. Knowledge about high risk of exposure keratopathy in ventilated patient was present in 93% (78%; 95% confidence interval [CI]) nurses. Only six nurses (5%) followed a strict protocol for eye care, 52 nurses (43%) checked for eyelid closure in the ventilated patients, and 58 (48%) cleaned the eyes frequently. Those who were aware of exposure keratopathy checked eyelid closure (73% vs. 48%) and cleaned eyes with saline gauze more frequently (24% vs. 4%). Nurses in cardiac ICU were significantly lesser aware of exposure complications compared to medical ICU nurses (40% reduction in awareness, 95% CI = 0.37-0.98, P = 0.04). Conclusion: Although there is high awareness, practice patterns of ICU nurses were less than desired. Educational initiatives should focus on weaknesses in knowledge and practice noted to improve eye care of patients in ICU.

Development and psychometric evaluation of a questionnaire on nurses' clinical competence eye care in intensive care unit patients.

BACKGROUND: Given the high prevalence of eye disorders in intensive care units, evaluating critical care nurses' competence in providing standard eye care is a matter of utmost importance. However, to the best of our knowledge, there is no valid questionnaire for measuring nurses' competence to undertake eye care. AIMS: The aim of this study was to develop and evaluate the psychometric properties of a questionnaire on nurses' clinical competence in providing eye care to patients hospitalized in intensive care units. DESIGN: This was a psychometric study. METHODS: We initially performed a literature review and developed a 38-item questionnaire consisting of knowledge, attitude and practice domains. We invited a panel of experts and a group of critical care nurses to assess the content and face validity of the questionnaire. Thereafter, we evaluated its construct validity by using the exploratory factor analysis and the known-groups comparison technique. Moreover, the test-retest and the internal consistency evaluation techniques were used for assessing the reliability of the questionnaire. RESULTS: Totally, 35 items remained in the final version of the questionnaire. Based on the results of the exploratory factor analysis, we categorized the items of the questionnaire into three factors. The Cronbach's alpha for the attitude and the practice domains as well as the Kuder-Richardson 20 for the knowledge domain showed satisfactory internal consistency. The Cronbach's alpha for the whole questionnaire also was 0·83. CONCLUSION: The results of this study suggest that the nurses' clinical competence in eye care questionnaire has a good factor structure and an acceptable reliability. RELEVANCE TO CLINICAL PRACTICE: A complication of sedation and coma is that some patients are unable to maintain effective eyelid closure. These patients present a higher risk of eye complications. Development of tools for evaluating nurses' competence in providing standard eye care is a fundamental prerequisite for improving the quality of eye care.

Development and validation of an eye care educational programme for intensive care unit nurses.

AIMS AND OBJECTIVES: To develop and validate an eye care educational programme for intensive care unit nurses. BACKGROUND: Eye care guidelines and protocols have been developed for increasing eye care implementation in intensive care units. However, the guidelines lack consistency in assessment or intervention methodology. DESIGN: This was a one-sample pre/postprogramme evaluation study design for testing the effects of the eye care educational programme, developed for and applied to intensive care unit nurses, on their levels of knowledge and awareness. METHODS: The eye care educational programme was developed based on literature review and survey of educational needs. Thirty intensive care unit nurses served as subjects for the study. RESULTS: The levels of eye care-related knowledge, awareness and practice were enhanced following the implementation of the educational programme. Moreover, satisfaction with the educational programme was high. CONCLUSION: It is necessary to intensify eye care education aimed at new nurses who are inexperienced in intensive care unit nursing and provide continuing education on the latest eye care methods and information to experienced nurses. RELEVANCE TO CLINICAL PRACTICE: The eye care educational programme developed in this study can be used as a strategy to periodically assess the eye status of patients and facilitate the appropriate eye care.

How to care for a patient's eyes in critical care settings.

Rationale and key points Eye care is an important aspect of the nursing management of patients who are critically ill. All patients in acute care settings with absent or compromised eye defence mechanisms are at risk of eye complications and ocular surface disease. This article aims to assist nurses to care for the eyes of patients in critical care settings to enable early detection and routine management of ophthalmic issues, thereby avoiding visual compromise on patient discharge from critical care settings. ¼ Corneal exposure is reported to occur in many patients who are critically ill. ¼ Incomplete eyelid closure and lack of lubrication are the main mechanisms that underlie the development of corneal damage in patients who are critically ill. ¼ Unconscious, sedated and/or paralysed patients and those with a reduced Glasgow Coma Scale score depend on healthcare professionals to maintain their ocular surface to prevent complications such as corneal abrasion, infection and ulceration, perforations and blindness. ¼ Meticulous nursing care is required to prevent ophthalmic complications that can result from corneal exposure in this patient group. Regular, evidence-based eye care should be part of routine nursing practice for patients who are critically ill. Reflective activity 'How to' articles can help you update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: 1. How this article might change your practice? 2. How you could use this resource to educate your colleagues in eye care of the unconscious patient?

Red eye emergencies in primary care.

Severe red eye conditions can be the result of intraocular inflammation, corneal insults or inflammation, and acute glaucoma. These pathologies require the knowledge and assessment tools of an ophthalmologist. This article will discuss red eye emergencies that the NP should promptly recognize and refer to ophthalmology.

Atención enfermera extrahospitalaria en una urgencia ocular. Gestión compartida de la demanda / Out-of-hospital nursing care in an eye emergency. Shared management of the demand

Dentro de la clasificación avanzada y gestión de la demanda urgente en puestos fijos de Atención Primaria y Hospitalizada, el triaje ha demostrado una gran eficacia en la gestión de las urgencias. Dada la elevada frecuentación de procesos banales o de menor entidad, y a fin de contribuir a mejorar la resolución de dicho problema, el Servicio Andaluz de Salud ha puesto en marcha un subproceso de consulta enfermera de urgencias, con el objeto de ser resolutiva en el tratamiento de procesos banales donde los pacientes hayan sido clasificados como prioridad 5. La aplicación del triaje, utilizando como herramientas la gestión compartida de la demanda y la administración avanzada de medicación, consigue mejorar la accesibilidad del paciente al intensificar los cuidados sobre él y abre una segunda puerta de acceso a la demanda asistencial urgente, estando actualmente limitada prácticamente al médico, además de aumentar la satisfacción por la asistencia. A pesar de los buenos resultados obtenidos y la evidencia disponible referente al triaje, es un proceso que no está establecido en todas las Unidades de Gestión Clínica de Atención Primaria del Servicio Andaluz de Salud. Es preciso investigar dichas herramientas aplicadas en la clasificación avanzada de urgencias en puestos fijos y en la actuación finalista en la consulta enfermera de urgencias. El objetivo del presente artículo es compartir, mediante la descripción de un caso clínico, la experiencia llevada a cabo en la Unidad de Gestión Clínica de Lora del Río (Sevilla), a fin de mostrar la capacidad de resolución del profesional enfermero en las urgencias extrahospitalaria utilizando la gestión compartida de la demanda

Within the advanced classification and management of emergency care demand in Primary and Hospital Care permanent positions, the triage has demonstrated great efficacy for managing emergencies. Given the high frequency of banal or minor episodes, and in order to contribute to an improved solution for said problem, the Andalusian Health System has established a sub-procedure of Emergency Nursing Care, in order to assist in the treatment of banal episodes, where patients have been classified as Priority 5. The implementation of the triage, using as tools the shared management of the demand and the advanced administration of medication, achieves an improved access for patients, by intensifying the level of care, and opens a second door of access to the urgent demand for care, which is nowadays practically limited to the physician, besides increasing the satisfaction for the care received. Even though good results have been obtained, and there is evidence available about the triage, this is a process which has not been established in all Primary Care Clinical Management Units in the Andalusian Health Service. Further research is required about said tools implemented in the advanced classification of emergencies in permanent positions and in the final action in the Emergency Nursing Office. The object of the present article is to share, through the description of a clinical case, the experience conducted in the Clinical Management Unit in Lora del Río, in order to show the problem-solving ability of nursing professionals in out-of-hospital emergencies, using the shared management of demand