Implementing Prone Positioning for COVID-19 Patients Outside the Intensive Care Unit.

Francisco, Mary Ann; Pierce, Nicole L; Ely, Elizabeth; Cerasale, Matthew T; Anderson, Daniela; Pavkovich, David; Puello, Frances; Tummala, Sandeep; Tyker, Albina; DʼSouza, Felicia R

BACKGROUND Proning intubated intensive care unit patients for the management of acute respiratory distress syndrome is an accepted standard of practice. We examined the nursing climate in 4 units and its impact on implementing a novel self-proning protocol to treat COVID-19 patients outside the intensive care unit. LOCAL PROBLEM Nursing units previously designated for medical/surgical populations had to adjust quickly to provide evidence-based care for COVID-19 patients attempting self-proning. METHODS Nurses from 4 nursing units were surveyed about the implementation process on the self-proning protocol. Their perception of unit implementation was assessed via the Implementation Climate Scale. INTERVENTIONS A new self-proning nursing protocol was implemented outside the intensive care unit. RESULTS Consistent education on the protocol, belief in the effectiveness of the intervention, and a strong unit-based climate of evidence-based practice contributed to greater implementation of the protocol. CONCLUSIONS Implementation of a new nursing protocol is possible with strong unit-based support, even during a pandemic.