RESUMEN
Objectives: Proning is an established technique for the care of intubated patients with severe respiratory failure. Positioning devices used to support the head and body of patients placed in the prone position are often associated with the formation of pressure injuries. Despite robust literature on the prevention and monitoring of pressure injuries, little is described about the role of proning pillows on pressure injuries. The objective of this review is to understand the extent of evidence pertaining to the safety and usability of different types of proning pillows in the intensive care setting. Review method: A scoping review of the literature was completed using predefined search terms in three databases and identified 296 articles. An additional 26 were included from reference lists. Twenty studies are included in the analysis;most were published in the past 3 years, with >50% in surgical settings. Data sources: Three databases were searched: PubMed, Scopus, and EMBASE. Review methods: The review followed the PRISMA Extension for Scoping Reviews, and data were reviewed using Covidence. Results: The most prevalent proning pillow is a standard, noncontoured foam head positioner. It is responsible for the majority of facial pressure injuries in all settings of care. Memory foam pillows and helmet-based systems offer improved surface pressure distribution, although their usability in the intensive care setting remains poorly studied. Inflatable air-cell-based devices present an alternative, but the lack of supporting research and the costs may explain their poor uptake. Several articles proposed the use of pressure sensor systems to evaluate devices. We propose a set of ergonomic parametres to consider when choosing or designing a positioning device for proned patients. Conclusion: The evidence pertaining to the safety and usability of proning pillows in the intensive care setting is scarce, which provides opportunities for future research to improve the efficacy in the prevention of pressure injuries and the user experience. © 2022
RESUMEN
Background: In America there are currently many older adults living alone in hopes of maintaining their independence. COVID-19 emphasized the pre-existing issue of social isolation among older adults, especially with society's ever-increasing dependence on technology. In response to the pandemic, the HealthWise program was created to teach older adults about technology, using Zoom©, to increase comfortability and confidence when using technology. Methods: To participate in HealthWise, participants needed to be 55 or better, have WIFI connection and the ability to participate in sessions for the duration of the program. All participants were assigned to trained coaches, who were students at Eastern Virginia Medical School. During the first session each participant signed a consent form and completed a 14-question survey. Questions included multiple choice and Likert scales pertaining to age, race, educational level, frequency of technology use, and their level of comfort using technology. One-hour sessions were conducted twice a week for three months. The goal was for participants to gain proficiency in the following skills: WIFI, Zoom ©, email and the Birdsong App, an internet- based software for older adults. Results: There were 66 participants total. 56% of all participants lived alone, while 24% lived with their spouse. 24% completed some college but have no degree, 20% had a bachelor's degree, 18% had a master's degree, 15% had a high school degree (or equivalent) and 12% had an associate degree. 88% of participants use technology more than five plus times per week, while only 12% use technology less than five times. Of those using technology consistently, only 40% are comfortable with their abilities. Participants with an associate degree or higher reported to be more comfortable using technology compared to participants with a high school education or lower (p-value, 0.025). Conclusion: The pre-survey data demonstrates there is a need within the older adult population to receive technological training. In addition, the data shows an interest among older adults to receive training despite education level and current levels of comfort using technology. Additional research will be conducted to gather data on retention of skills and comfortability using technology.