Impact of a structured educational intervention on the prevention of ocular surface disorders in critically ill patients: A non-randomized clinical trial.

INTRODUCTION

Ocular surface disorders (OSDs) are common in intensive care unit (ICU) patients, with incidence rates ranging from 13.2% to 59.4%. Risk factors include impaired eyelid closure, reduced blink reflexes, and systemic inflammation, exacerbated by sedation and mechanical ventilation. Despite these risks, ICU nurses often lack standardized ocular care training, leading to inconsistent practices and suboptimal patient outcomes.

AIM: To evaluate the impact of a structured educational intervention on ICU nurses' regarding ocular care in critically ill patients.

METHOD: A non-randomized clinical trial was conducted in a tertiary hospital in Spain, including 161 ICU patients (80 pre-intervention; 81 post-intervention) requiring ≥ 48-hour mechanical ventilation and sedation. The study involved a pre-intervention observational phase followed by a structured educational program for ICU nurses on evidence-based ocular care consisting of a one-hour in-person session combining theoretical content, bedside demonstration, and distribution of supporting visual materials. Clinical outcomes and adherence to care protocols were analysed using chi-square tests, t-tests, and logistic regression.

RESULTS

The incidence of OSDs decreased from 76.3 % pre-intervention to 38.3 % post-intervention (p < 0.001). Significant reductions were observed in dry eye (40 % to 9.9 %), lagophthalmos (43.8 % to 19.8 %), red eye (38.8 % to 12.3 %), and ocular oedema (48.8 % to 29.6 %). Early ocular care implementation increased from 33.8 % to 71.6 % (p < 0.001), and adherence to evidence-based care protocols improved from 80 % to 93.8 % (p < 0.01). Post-intervention care was strongly associated with a lower OSD risk (adjusted OR: 0.21; 95 % CI: 0.11-0.43; p < 0.001).

CONCLUSION

A structured educational intervention significantly reduced the incidence of OSDs and improved adherence to evidence-based ocular care practices in ICU settings.

IMPLICATION FOR CLINICAL PRACTICE: Integrating evidence-based ocular care protocols into ICU routines reduces OSD incidence and enhances patient outcomes. Nurses training and institutional support are essential for sustaining adherence, improving patient safety, and minimizing preventable ocular complications in critically ill patients.