Proning the ICU patient isn’t for the faint of heart, it takes planning, communication, collaboration and coordination and an OR nurse. It takes a team of 6-8 depending on the size of the patient to safely transfer that patient into the prone position. The key word in the sentence above is safety.
Things to plan for when you prone a patient:
- There needs to be a leader to coordinate the effort
- The patient is usually paralyzed so they can not help you at all
- Because the patient is paralyzed their limbs and head need to be managed to avoid injury
- They are usually intubated and have multiple lines to manage
- Use a proning aid during the proning process to ensure safe patient handling per AORN guidelines
- Do not use non-evidence-based prone positioning devices like pillows
- Protect the skin from moisture and shearing forces by utilizing foam dressings for high risk areas.
Think about using a specialized proning team and standardize the process. Standardized process and the use of highly skilled specialized teams have been shown to improve patient outcomes. The vascular access team, the Emergency response team and the wound care team are examples of those specialized teams.
Create your proning team by using OR nurses as they are the experts and are available due to the elimination of “Non-Essential Surgery”. By creating a proning team your facility will have decreased patient injures and increased nursing satisfaction. The ICU nurses will have more time to spend caring for the critical patient when using the proning team.
Remember, utilize the expert for great patient outcomes!
Please read the COVID-19 guidelines and resources that we have gathered to help support your patient care efforts:
Pressure Injury Prevention– PIP Tips for Prone Positioning
NPIAP Protecting Facial Skin Under PPE N95 Face Masks Infographic
