(425) Identifying and Improving Correctable Vision Deficits in the Intensive Care Unit

Introduction: Eyeglass use is often disregarded in the Intensive Care Unit (ICU) as life-saving care takes precedent. However, because of this those with visual impairments are left without the full use of one of the most basic senses. This is especially detrimental in the elderly population who have higher rates of eyeglass use in general. This study aimed to identify eyeglass use in ICU patients at a mid-sized urban center as well as improve their use by patients.

Methods: In July of 2023 eyeglass in the ICU use was identified as a Quality Improvement (QI) target. The outcome measure for this project was number of patients wearing glasses with a goal of 15% of patients wearing glasses at 9 months. The balancing measure was lost devices and/or falls, and the process measures were availability and documentation of glasses. In December of 2023, patients with documented use of glasses had a sign hung in their room to remind care teams of their need and encourage their use. Surveys of the QI measurers were conducted weekly. Members of the nursing and resident staff were also designated as representatives to advocate for the initiative in the ICU as well as educate other staff and patient families.

Results: 212 patients were surveyed after the initiative was implemented, with 110 (51.9%) of them having documented glasses use at home. Post intervention, the average rate of eyeglasses used in the ICU increased to 12.8% up from 0% prior. Additionally, rates of glasses availability increased to 25.1% from 17.6% while documentation of glasses use in EPIC flowsheets increased to 36.4% from 22.2%. The average rate of eyeglass sign use however, was only 15.9%. Finally, there were 0 falls or loss of devices.

Conclusions: The rates of eyeglasses use was able to be increased after the initiative. Additionally rates of availability and documentation of eyeglasses were also improved. However, some representatives felt the eyeglass sign was cumbersome and difficult to integrate into their workflow, likely contributing to the relatively low rate of sign use. In the future the eyeglass sign will be integrated into the room whiteboard to become part of the admission workflow with a goal to increase use of the sign as well as the percentage of patients wearing their eyeglasses in the ICU.