Evidence-Based Nursing Interventions and Guidelines for Prone Positioning of Adult; Ventilated Patients: a Systematic Review

ABSTRACT

Although the prone positioning of a critically ill patient poses a challenge to nursing interventions; it remains the responsibility of nurses to develop a way to provide the same basic and intensive care to those patients lying prone as to those lying supine. The purpose of this study was firstly to conduct a systematic review of the literature as explora-tion and description of the evidence in support of the beneficial nursing interventions during prone positioning of ventilated patients; and secondly to develop evidence-based nursing guidelines for 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 was extracted onto data abstraction forms; assessed for methodological quality and finally summarised in 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 partial pressure of oxygen in arterial blood (PaO2) weighted mean difference (WMD CI = 11.36; 31.8). The effects of complications; oxygenation and haemodynamic outcomes compared with the different prone-positioning protocols produced in conclusive results. Nursing guidelines for prone positioning were developed based on the best available evidence. The lack of related articles on nursing care of prone positioning was a drawback. Based on these results; recommendations are made towards further study on the nursing care of prone-positioned patients