PMID- 33725746
OWN - NLM
STAT- MEDLINE
DCOM- 20220628
LR  - 20220727
IS  - 1478-5153 (Electronic)
IS  - 1362-1017 (Print)
IS  - 1362-1017 (Linking)
VI  - 27
IP  - 4
DP  - 2022 Jul
TI  - Nursing care and prevalence of adverse events in prone position: Characteristics 
      of mechanically ventilated patients with severe SARS-CoV-2 pulmonary infection.
PG  - 493-500
LID - 10.1111/nicc.12606 [doi]
AB  - BACKGROUND: Because of the coronavirus disease 2019 (COVID-19) pandemic, the use 
      of prone positioning has dramatically increased in the intensive care unit (ICU). 
      Because this manoeuvre is related to several complications, it must be performed 
      in a protocolized manner by the appropriate personnel. AIM: To determine the 
      prevalence of adverse events (AEs) in patients admitted to the ICU with a 
      diagnosis of COVID-19-related acute respiratory distress syndrome (C-ARDS) 
      undergoing mechanical ventilation in prone position (PP). DESIGN: Descriptive 
      ambispective study of patients admitted to the ICU diagnosed with C-ARDS 
      undergoing mechanical ventilation who were in the PP at least once. The number of 
      PP manoeuvres and the time spent in the PP were recorded for each subject. AEs 
      proportions and frequencies were calculated, and analysis of variance was used to 
      assess mean differences in the number of manoeuvres and total hours in PP 
      stratified by the number of facial pressure ulcers. IBM SPSS Statistics v.25.0. 
      and EPIDAT 4.1 software were used. RESULTS: Forty-four patients were analysed, 
      and 130 PP manoeuvres were performed. The most frequently observed AEs were 
      facial oedema in 26 patients (80.3%) and facial pressure ulcers in 20 (60.6%). 
      There was a significant positive association between the time spent in PP and the 
      development of facial pressure ulcers (P < .001). Enteral nutrition was well 
      tolerated, and no serious AEs or sentinel events were noted. CONCLUSION: Despite 
      the stressful, demanding situation during the peak of the pandemic, the large 
      number of PP manoeuvres, and long duration spent in this position, no serious AEs 
      occurred. This study highlights the need to implement preventive measures to 
      avoid the development of pressure ulcers secondary to prone positioning. 
      RELEVANCE TO PRACTICE: Prone positioning requires a nursing protocol to prevent 
      the occurrence of AEs that may reduce the quality of nursing care.
CI  - (c) 2021 British Association of Critical Care Nurses.
FAU - Rodriguez-Huerta, Maria Dolores
AU  - Rodriguez-Huerta MD
AD  - Intensive Care Unit, La Princesa University Hospital, Madrid, Spain.
FAU - Diez-Fernandez, Ana
AU  - Diez-Fernandez A
AUID- ORCID: 0000-0002-7673-986X
AD  - Faculty of Nursing, Universidad de Castilla-La Mancha, Cuenca, Spain.
AD  - Centro de Estudios Sociosanitarios, Universidad de Castilla-La Mancha, Cuenca, 
      Spain.
FAU - Rodriguez-Alonso, Maria Jesus
AU  - Rodriguez-Alonso MJ
AD  - Intensive Care Unit, La Princesa University Hospital, Madrid, Spain.
FAU - Robles-Gonzalez, Maria
AU  - Robles-Gonzalez M
AD  - Intensive Care Unit, La Princesa University Hospital, Madrid, Spain.
FAU - Martin-Rodriguez, Maria
AU  - Martin-Rodriguez M
AD  - Nuestra Senora de Sonsoles Hospital, Avila, Spain.
FAU - Gonzalez-Garcia, Alberto
AU  - Gonzalez-Garcia A
AD  - Centro de Estudios Sociosanitarios, Universidad de Castilla-La Mancha, Cuenca, 
      Spain.
AD  - Faculty of Health Sciences, University of Granada, Granada, Spain.
LA  - eng
PT  - Journal Article
DEP - 20210316
PL  - England
TA  - Nurs Crit Care
JT  - Nursing in critical care
JID - 9808649
MH  - *COVID-19/epidemiology
MH  - Humans
MH  - *Pressure Ulcer/epidemiology/etiology
MH  - Prevalence
MH  - Prone Position
MH  - Respiration, Artificial/adverse effects
MH  - *Respiratory Distress Syndrome/epidemiology/therapy
MH  - SARS-CoV-2
PMC - PMC8251070
OTO - NOTNLM
OT  - COVID-19
OT  - adverse events
OT  - nursing care
OT  - pressure ulcers
OT  - prone position
EDAT- 2021/03/17 06:00
MHDA- 2022/06/29 06:00
PMCR- 2021/03/16
CRDT- 2021/03/16 20:22
PHST- 2021/02/02 00:00 [revised]
PHST- 2020/08/06 00:00 [received]
PHST- 2021/02/03 00:00 [accepted]
PHST- 2021/03/17 06:00 [pubmed]
PHST- 2022/06/29 06:00 [medline]
PHST- 2021/03/16 20:22 [entrez]
PHST- 2021/03/16 00:00 [pmc-release]
AID - NICC12606 [pii]
AID - 10.1111/nicc.12606 [doi]
PST - ppublish
SO  - Nurs Crit Care. 2022 Jul;27(4):493-500. doi: 10.1111/nicc.12606. Epub 2021 Mar 
      16.