الفهرس 
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Abstract
Eye care among critically ill patients in ICU remained a public health problem worldwide. The unconscious mechanically ventilated cases are at high possibility for development of eye complications ranging from mild conjunctivitis to serious corneal injury and ulceration with subsequent development of eye perforation and blindness (Bendavid et al., 2017). ICU nurses play a major role in prevention as well as management of eye complication in those individuals. Proper assessment and follow up of well-established protocol contribute to early recognition and treatment of critical cases are responsible for better outcomes with low incidence of ocular complications (Kocacal, 2018).
Aim of the study:
The aim of this study was to assess nurses’ performance regarding eye care among unconscious critically ill patients through the following:
1- Assess nurses’ knowledge regarding eye care among unconscious critically ill patients.
2- Assess nurses’ practices regarding eye care among unconscious critically ill patients.
Research questions :
- What is the level of nurses’ knowledge regarding eye care among unconscious critically ill patients?
- What is the level of nurses’ practices regarding eye care among unconscious critically ill patients?
Research Design
A descriptive exploratory design was used to conduct this study.
Study Settings
The study was carried out at Medical Intensive Care Units at Ain Shams University Hospital.
Subjects:
Convenient sample of (30) nurses who were included in the previously-mentioned settings from both gender and provided care among unconscious critically ill patients.
Tools of data collection:
Tool (I): Nurses’ self-administered questionnaire:
It was developed by the investigator after reviewing the related literature and reviewed by supervisors. It was written in an Arabic language for gathering data in relation to the following parts:
1- : Nurses’ demographic data: This part used to assess nurses’ demographic characteristics.
2- : Nurses’ knowledge questionnaire: This part concerned with assessing nurses’ knowledge level regarding eye care among unconscious critically ill patients.
Tool (II): Nurses’ observational checklist:
It was adapted from (Azfar et al., 2013/ Kam et al., 2011). This tool included 2 parts:
1- Nurses’ assessment of patients’ eye health status: It was used to assess patients’ eye health status mainly concerned with four (4) items eyelid assessment, conjunctiva assessment, corneal assessment and eye exposure assessment.
2- Nurses’ practice assessment was used to assess nurses’ practice level regarding eye care among unconscious critically ill patients, mainly concerned with cleansing of the eye, instilling eye drops, administering eye ointment, administering an eye irrigation, applying eye dressing (Polyethylene cover).
Results:
This study revealed the following results:
❖ 66.7% of studied nurses had unsatisfactory knowledge regarding eye care, while 33.3% of studied nurses had satisfactory knowledge regarding eye care.
❖ 73.3% of studied nurses had unsatisfactory practice regarding eye care and 26.7% of them had satisfactory practice.
❖ There were highly statistically significant relations between total knowledge of studied nurses and qualifications, experiences and training courses at p. value <0.001.
❖ There were highly statistically significant relations between total practice of studied nurses and qualifications, training courses at P. value <0.001.
❖ There was highly positive correlation between total knowledge and total practice of the studied nurses regarding eye care among unconscious critically ill patients.
Conclusion:
More than half of studied nurses had unsatisfactory knowledge regarding eye care and more than two thirds of studied nurses demonstrated unsatisfactory practice regarding eye care. There were highly statistically significant relations between total knowledge of studied nurses and qualifications, experiences and training courses and there were highly statistically significant relations between total practice of studied nurses and qualifications, training courses.
Recommendations:
● Nurses need continuous education and clinical training programs about eye assessment protocol and care of unconscious ventilated patients that can be supportive to nurses in critical care units, by placing strong emphasis on theoretical and skill development.
● Establishment of a written update protocol of eye care among unconscious critically ill patients in ICU departments to ensure enough knowledge, and safe practices.
● Nurses frequent assessment of eye health status and eye care should be maintained and recorded in nursing records and ICU nurses should be aware about the development of dry eye, keratopathy, and ocular infections with rapid consultation of ophthalmologist for early diagnosis of ocular surface disorders.
● Regular follow up of eye condition to determine whether the condition resolve or become more complicated and using of eye drops to prevent dryness of eye with subsequent more complications.
● Additional care for mechanically ventilated cases more than non-ventilated ones as sedating agents induce impairment of blinking reflex with subsequent more complications.