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Dry Eye in Critically Ill Patients: Evidence-Based Study

Purpose of the Study

The study’s objective is to determine which method of nursing intervention, liquid artificial tears or artificial tears gel, would be most effective in reducing or preventing dryness in ICU patients. Due to conditions and medications that patients have in the ICU, they cannot produce adequate moisture in their eyes, resulting in discomfort and damage to the ocular surface. Nurses, as primary caregivers, have the role of reducing such preventable conditions use available evidence-based methods.

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Research & Design

It is a double-blind, randomized controlled trial. This type of research design is highly effective in achieving objectivity due to the anonymous, highly randomized process that even the researchers are unaware of during the process, helping to eliminate bias.


The final sample consists of 140 patients, which were equally distributed into both intervention groups. Patients had to be aged 18 or older and admitted into the ICU. The researchers used their sample from a tertiary hospital in Brazil with family members giving consent. Patients to meet several criteria such as no diagnosis of brain death or dry upon admission, the ICU stay had to be for longer than 48 hours, and receive mechanical ventilation. Participants also had to bling five times or less per minute and score seven or lower on the Glasgow Coma Scale.

Data Collection

The ocular assessment was the primary method of data collection. For five consecutive days, researchers would observe and evaluate patients using the Schirmer test to measure tear volume and the fluorescein eye stain test to identify abnormalities in the cornea. Measures were taken to ensure the researcher did not know which substance was used to maintain the double-blind integrity of the study.

Data Analysis

Data was input into the Epi Info software program by two researchers independently and then verified for consistency. It was then imported into the R-3.2.3 software for statistical analysis. The standard tests were run, such as average, standard deviation, and frequency. Variables were analyzed categorically by the Fisher exact test, continuous variables through the Mann-Whitney test and the normalcy of distribution of variables through the Shapiro-Wilk test.


The study noted that it did not test some of the more traditional clinical interventions for dry eye, such as polyethylene film. Potentially, this can negatively influence the implications of the study since these proposed intervention groups are not commonly used. Therefore, being able to compare them with a control group of a standard clinically recommended practice would have been more effective.


The incidence of dry eye was lower in the artificial tears gel group at 9% (incidence of 1.72 per 100) rather than the tears liquid at 21%. I found it interesting how the researchers also compared the participants finding no statistical differences at baseline, suggesting that the randomization was effective and its results more valid.

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Reading Research Literature

Evidence-based literature is an inherent part of nursing practice, helping to drive forward the most effective and safe care. Nurses are expected to keep up with literature such as this to apply it to their practice, ensuring that patients are receiving the best treatments and care. Since research literature follows a meticulous process of approval, research, and then peer-review, the knowledge provided in such studies is more likely to be valid. Completing the research literature worksheet helped me understand the numerous components of a study and how each one matters significantly in achieving objectivity. It may help me in developing my own future research as a healthcare professional.


De Araujo, D. D., Silva, D. V. A., Rodrigues, C. A. O., Silva, P. O., Macieira, T. G. R., & Chianca, T. C. M. (2019). Effectiveness of nursing interventions to prevent dry eye in critically ill patients. American Journal of Critical Care, 28(4), 299-306. Web.

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StudyCorgi. (2021, July 23). Dry Eye in Critically Ill Patients: Evidence-Based Study.

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