Evidence-based nursing guidelines for prone positioning of adult, ventilated patients.
Article Type: Brief article
Subject: Evidence-based nursing (Standards)
Ventilators (Usage)
Ventilators (Health aspects)
Practice guidelines (Medicine)
Authors: Nortje, Suegnet
Nel, Elzabe
Nolte, Anna
Pub Date: 08/01/2007
Publication: Name: Southern African Journal of Critical Care Publisher: South African Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2007 South African Medical Association ISSN: 0038-2469
Issue: Date: August, 2007 Source Volume: 23 Source Issue: 1
Topic: Event Code: 350 Product standards, safety, & recalls
Product: Product Code: 3841563 Respirators NAICS Code: 339113 Surgical Appliance and Supplies Manufacturing SIC Code: 3842 Surgical appliances and supplies
Geographic: Geographic Scope: South Africa Geographic Code: 6SOUT South Africa
Accession Number: 168164869
Full Text: Prone positioning of a critically ill patient poses a challenge to nursing interventions, but it remains the responsibility of nurses to develop a way to provide the same basic and intensive care to patients lying prone as opposed to patients lying supine. The purpose of this study was to do a systematic review in order to explore the evidence in support of the beneficial nursing interventions during prone positioning of ventilated patients and to develop evidence-based nursing guidelines with regard to the nursing process. This exploratory, descriptive and retrospective systematic review includes data from 45 clinical trials, with a total population of 2 148 patients. Data were extracted onto data abstraction forms, assessed for methodological quality and summarised into evidence tables. All statistical calculations for the meta-analysis were performed by the RevMan 4.2.8 program. Prone positioning showed significant (p < 0.0001) increases in the Pa[O.sub.2] (WMD = 11.43 ) and the Pa[O.sub.2/Fi[O.sub.2] ratio (WMD = 21.58, 95% CI = 11.36; 31.8). The effects of complications, oxygenation and haemodynamic outcomes compared against the different prone positioning protocols had inconclusive results. Nursing guidelines to prone positioning were developed based on the best available evidence. The lack of nursing-care related articles on prone positioning was a major drawback. Based on these results, recommendations are made towards further study on the nursing care of prone-positioned patients.
Gale Copyright: Copyright 2007 Gale, Cengage Learning. All rights reserved.