Development of prone positioning and skin damage prevention digital education: the PRONEtect project

Author:

Fourie Anika1,Ahtiala Maarit2,Black Joyce3,Campos Heidi Hevia4,Coyer Fiona56,Gefen Amit7,LeBlanc Kim89,Smet Steven110,Vollman Kathleen11,Walsh Yolanda12,Beeckman Dimitri113

Affiliation:

1. Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery (UCVV), Department of Public Health and Primary Care, Ghent University, Ghent, Belgium

2. Service Division, Perioperative Services, Intensive Care Medicine and Pain Management, Turku University Hospital, Turku, Finland

3. University of Nebraska Medical Center, College of Nursing, Omaha NE, US

4. Adult Health Graduation Program, School of Nursing, University of São Paulo, Brazil

5. Intensive Care Services, Royal Brisbane and Women's Hospital, Brisbane, Australia

6. School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia

7. Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, Israel

8. Wound, Ostomy and Continence Institute, Nurses Specialized in Wound, Ostomy and Continence, Canada

9. Affiliate Faculty, Ingram School of Nursing, Faculty of Medicine, McGill University, Quebec, Canada

10. Wound Care Center, Ghent University Hospital, Ghent, Belgium

11. Advancing Nursing LLC, Adjunct Faculty Michigan State University, Northville MI, US

12. YL Walsh (Pty) Ltd, Adjunct Lecturer Stellenbosch University, Western Cape, South Africa

13. Swedish Centre for Skin and Wound Research, School of Health Sciences, Örebro University, Örebro, Sweden

Abstract

Objective: The incidence of skin/tissue damage, such as pressure ulcers, remains high in mechanically ventilated patients in the prone position. According to guidelines, critically ill patients with acute respiratory distress syndrome (ARDS) should be prone for at least 12–16 hours to improve oxygenation and decrease mortality. Therefore, educating clinicians on how to reposition and manage the patient safely in a prone position plays a vital role in preventing adverse events. This project aimed to develop accessible online educational content to assist clinicians in safely executing the prone manoeuvre and minimise skin/tissue damage. Method: The development of the educational content was based on: a gap analysis and comprehensive review of available educational resources; evidence-based scientific literature; advice from international experts; and a qualitative study exploring the learning needs of 20 clinicians in Belgium and Sweden between February–August 2022. Results: Volunteer clinicians assisted with the creation of eight simulation videos which were professionally filmed and edited. The interactive videos included the supine-to-prone and prone-to-supine manoeuvres, endotracheal and nasogastric tube securement, eye care, stoma care, protecting high-risk areas from pressure damage, and incontinence-associated dermatitis prevention. A prone positioning protocol, a checklist summarising the key aspects of the protocol, and teaching aids (slide deck for didactic lecturing) were developed and validated by a review of the relevant evidence-based literature and the international expert panel. A website was designed to host the content, with free user access, at www.pronetection.com . Conclusion: Education is one strategy towards prevention of complications of prone positioning. Accessible education could assist clinicians unfamiliar with prone positioning or current clinicians requiring refresher training to safely manage patients in this position.

Publisher

Mark Allen Group

Subject

Nursing (miscellaneous),Fundamentals and skills

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