Ventilated patients in intensive care units are at particular risk of developing ocular damage . The practical application of the eye care given by critical nurses to critically ill patients varies widely . The study aimed to determine the impact of a competency - based protocol including the acceptable standards for contemporary practice , in an endeavor to improve such practices . Thirty - six experienced nurses were included . Non - participant observation has been carried out for 72 episodes of eye care . Nurse ' theoretical knowledge and the standard of eye care actually delivered were assessed . The main findings of the present study shows that the performance of the studied nurses and the related theoretical issues for eye care of ventilated patients fall far of being acceptable . As in other studies to observe nursing procedure accurately and in details , there was no demonstrable relationship between clinical practice and knowledge . Reassessment three months later revealed that the training protocol had a positive impact on the quality of eye care given by critical care nurses to ventilated patients . Eye care actices were competently carried out by the majority of the nurses and a significant improvement has been found . It has been concluded that 1 ] competency based training protocols can be the first step in the improvement of eye care practices given by nurses to ventilated patients in intensive care units.2 ] eye care practices for ventilated patients should urgently be improved . 3 ] Reassessment of the interface between education , research and real life professional practice as it is now and that is likely to become in the near future is needed in an endeavor to ameliorate practices . 4 ] Raising awareness and improving practice by competency - based training is necessary unlike arguments against theoretical backgrounds as unnecessarily redundant and time consuming . 5 ] Generalizability of competency based training to other groups of ventilated patients is recommended . 6 ] Further research studies are needed concerning the feasibility of different techniques used in eye care , together with intervention and outcome studies.