• Am. J. Crit. Care · Jan 2022

    Pressure Injury Outcomes of a Prone-Positioning Protocol in Patients With COVID and ARDS.

    • Connie Johnson, Nicholas A Giordano, Lopa Patel, Karyn A Book, Jennifer Mac, Janet Viscomi, April Em, Anna Westrick, Monika Koganti, Mindaline Tanpiengco, Karen Sylvester, and Kari A Mastro.
    • Connie Johnson is a wound care nurse and ostomy management specialist, Penn Medicine Princeton Health, Plainsboro, New Jersey.
    • Am. J. Crit. Care. 2022 Jan 1; 31 (1): 344134-41.

    BackgroundDuring the COVID-19 outbreak, standard methods for treating acute respiratory distress syndrome (ARDS) were used for patients presenting with ARDS. One such treatment method involves placing patients prone to improve oxygenation and reduce mortality risk. Challenges in preventing pressure injuries in patients placed prone have been reported, and no studies have explored the effects of including a certified wound and skin care nurse as part of the care team on the incidence of pressure injuries in SARS-CoV-2-infected patients with ARDS.ObjectivesTo evaluate the association between including a certified wound and skin care nurse on a multiprofessional pronation team and prevention of pressure injuries in SARS-CoV-2-infected patients with ARDS.MethodsThis multicenter observational cohort study used retrospective data from the electronic health record. The intervention group consisted of SARS-CoV-2-infected patients diagnosed with ARDS who were treated by a multidisciplinary prone-positioning team that included a certified wound and skin care nurse specialist. The comparison group of SARS-CoV-2-infected patients with ARDS was treated by a multidisciplinary prone-positioning team that did not include a certified wound and skin care nurse specialist.ResultsAs shown by multivariable logistic regression mixed-effect modeling, patients in the intervention group had a 97% lower adjusted odds ratio of a pressure injury developing than did patients in the comparison group (0.03 [95% CI, 0.01-0.14]; P < .001).ConclusionThe inclusion of a certified wound and skin care nurse on a multiprofessional prone-positioning team significantly reduced the odds of pressure injuries developing in patients infected with SARS-CoV-2.©2022 American Association of Critical-Care Nurses.

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