Prone Positioning in Patients With Acute Respiratory Distress Syndrome and Other Respiratory Conditions: Challenges, Complication, and Solutions

Authors

  • Lea Anne Gardner, PhD, RN Patient Safety Authority

DOI:

https://doi.org/10.33940/data/2020.12.1

Keywords:

patient safety, prone, proning, acute respiratory distress syndrome, ARDS, respiratory failure, pneumonia

Abstract

Acute respiratory distress syndrome (ARDS) and respiratory failure are characterized by hypoxemia (i.e., low levels of blood oxygen). Infections such as influenza and COVID-19 can lead to ARDS or respiratory failure. Treatment is through supportive measures. In severe cases, patients receive oxygen through a ventilator and, when appropriate, are placed in a prone position for an extended period. A retrospective review of events submitted to the Pennsylvania Patient Safety Reporting System (PA-PSRS) identified 98 prone position–related events in patients with ARDS, respiratory failure, distress, and pneumonia from January 1, 2010, through June 30, 2020; 30 events were associated with COVID-19. Skin integrity injuries accounted for 83.7% (82 of 98) of the events. The remaining events, 16.3% (16 of 98), involved unplanned extubations, cardiac arrests, displaced lines, enteral feedings, medication errors, a dental issue, and posterior ischemic optic neuropathy.

Author Biography

Lea Anne Gardner, PhD, RN, Patient Safety Authority

Lea Anne Gardner (leagardner@pa.gov) is a patient safety analyst with the Patient Safety Authority. She has more than 30 years of research experience in patient safety, performance improvement, cardiology, and behavioral health, and a diversified work experience, including roles as a national director of quality improvement and population health and institutional review board administrative director, a coronary intensive care nurse, a clinical research nurse, and a nurse research/leadership preceptor.

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Published

2020-12-17

How to Cite

Gardner , L. A. (2020). Prone Positioning in Patients With Acute Respiratory Distress Syndrome and Other Respiratory Conditions: Challenges, Complication, and Solutions. Patient Safety, 2(4), 11–23. https://doi.org/10.33940/data/2020.12.1

Issue

Section

Original Research and Articles
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