Effectiveness of Nursing Interventions to Prevent Dry Eye in Critically Ill Patients

Diego Dias de Araujo, PhD, MSN, RN; Daniel Vinicius Alves Silva; Carolina Amaral Oliveira Rodrigues; Patricia Oliveira Silva; Tamara Goncalves Rezende Macieira, BSN; Tania Couto Machado Chianca, PhD, MSN, RN


Am J Crit Care. 2019;28(4):299-306. 

In This Article



In total, 140 patients were included and randomized in the study. No statistically significant differences were found between the 2 groups at baseline (P ≤ .05; Table 1 and Table 2), confirming that randomization was sufficient to match the groups. The fluorescein eye test indicated the presence of corneal ulceration in 1 participant treated with liquid artificial tears and 2 participants treated with artificial tears gel (Table 2; P > .99).

Development of dry eye

Table 3 shows the incidence of the primary outcome (dry eye) during the 5-day evaluation period. On the fifth day of hospitalization, dry eye was present in 21% of patients (incidence rate of 4.28 per 100 patient-days) in the liquid artificial tears group and 9% of patients (incidence rate of 1.72 per 100 patient-days) in the artificial tears gel group.

The RR estimated for the effect of the intervention was 0.400 (95% CI, 0.166–0.964; P = .04; Table 4), indicating that the chance of dry eye developing was twice as high in the liquid artificial tears group as in the artificial tears gel group. The effect of the artificial tears gel intervention remained statistically significant (P = .04) after model adjustment for the risk factors (age, sex, and ocular surface exposure) identified in the sample (Table 4).

"The nursing team should identify risk factors for dry eye as soon as a patient is admitted to the ICU and then implement the needed interventions, such as artificial tears gel."