ABSTRACT
A survey of human factors practitioners working in health care was administered to understand their challenges and successes encountered when responding to the COVID-19 pandemic. Focus areas identified by survey respondents related to workflow, physical environments, communication, and implementation of new technologies. The results from this study can be used by human factors practitioners to demonstrate the common challenges and opportunities for applying human factors to system redesign within their health care organizations. These findings can also be used to encourage investments in human factors by health care organizations and the federal government.
ABSTRACT
OBJECTIVE: To identify and critically evaluate methods for proning patients with COVID-19 in the intensive care unit (ICU). BACKGROUND: Acute respiratory distress syndrome (ARDS) is common in hospitalized patients with COVID-19. Proning improves blood oxygenation and survival rates in these patients but is not commonly performed due to the difficulty of the procedure. METHODS: An academic literature review, internet video search, and consultation with five subject-matter experts was performed to identify known methods for proning. Evaluation of each method considered the number of healthcare workers required, physical stresses on staff, risk of adverse events to patients, and equipment cost and availability. RESULTS: Several variations of manual techniques and-lift assisted techniques were identified in addition to a specialized proning bed. Manual methods require more healthcare workers, higher physical stresses, and greater risk of adverse events than lift-assisted methods or the proning bed. CONCLUSION: Both the specialized proning bed and a lift-assisted method using straps largely eliminated manual forces required for proning while allowing for a controlled lowering and positioning of the patient. APPLICATION: This review will guide practitioners to the most suitable methods for proning patients in the ICU.