Construction Of Comprehensive Prevention And Nursing Program Of Exposed Keratitis In ICU Patients

Research Purpose:To construct scientific and effective comprehensive prevention and care program of exposed keratitis for critically ill ICU patients based on evidence-based theory and eye care guidelines.Make clear the specific implementation content of ICU nurse education and training,eye care evaluation and EK preventive care.It provides scientific and operable theoretical basis for EK preventive care in ICU.Research Methods:1.Set up a research group and determine the research theme and program design.2.Evidence-based nursing research combined with research group discussion to form the draft plan.The research process includes literature guide search of domestic and foreign databases,and End Note Document manager for document duplication,and research group literature screening,literature evaluation,data extraction,evidence summary.Finally,combined with group discussion and analysis,the draft of comprehensive prevention and care program for ICU patients with exposed keratitis was formed.3.Delphi letter consultation method to determine the final draft of the plan.Eighteen experts in critical care and ophthalmology were selected for the study,and two rounds of expert correspondence were conducted.The contents of the scheme were modified and improved in combination with experts’ opinions and suggestions.The results of the correspondence inquiry were statistically analyzed.Research Results:A total of 34 literatures were included in this study,including 1 clinical practice guidelines,4systematic reviews,13 randomized controlled trial studies（RCTS）,8 quasi-experimental studies,5 cohort studies,2 descriptive studies,and 1 expert consensus.The preliminary comprehensive preventive and nursing program of exposed keratitis for critically ill patients in ICU includes 3first-level items,18 second-level items and 48 third-level items.The specific content covers three fields: nurse education and training,eye assessment and EK preventive nursing.The positive coefficients of the two rounds of expert letter consultation were 100%.The expert authority coefficient of the first round was 0.78,the expert authority coefficient of the second round was0.79.Degree of concentration of expert opinions（mean value range of each item in the first round3.77-4.94,percentage range 0.17-0.94,mean value range of each item in the second round3.94-4.94,percentage range 0.11-0.94）.Kendall’s harmony coefficient ranged from 0.21 to 0.23（P< 0.001）and variation coefficient ranged from 0.05 to 0.26 in the first round of correspondence.In the second round of correspondence,Kendall’s harmony coefficient ranged from 0.24 to 0.34（P< 0.001）and coefficient of variation ranged from 0.05 to 0.22.After two rounds of letter consultation,the final scheme contains 3 first-level items,17 second-level items and 43 third-level items.Research Conclusion:In this study,the comprehensive prevention and nursing program of exposed keratitis in critically ill ICU patients constructed based on evidence-based method and Delphi letter consultation method is scientific,reliable,comprehensive and practical.It can guarantee the overall safety of patients’ eyes.To provide theoretical basis for the preventive care of EK in ICU patients.