Imbriaco Guglielmo, Monesi Alessandro, Mazzoli Carlo Alberto, Gamberini Lorenzo, Ferrari Patrizia
Centrale Operativa 118 Emilia Est, Prehospital Emergency, Helicopter Emergency Medical Service, Maggiore Hospital Carlo Alberto Pizzardi, Bologna, Italy.
Critical Care Nursing Master Course, University of Bologna, Bologna, Italy.
Trends Anaesth Crit Care. 2022 Aug;45:37-41. doi: 10.1016/j.tacc.2022.05.002. Epub 2022 May 18.
Prone positioning is a complex, time-consuming task, involving significant intensive care unit staff. The increased workload during the COVID-19 pandemic and the reduced staffing boosted the burden of intensive care unit nurses, which might have a negative impact on patients' safety and outcomes.
Retrospective chart review, analysing the hourly distribution of pronation and supination procedures in mechanically ventilated critically ill patients during the first and the second wave of the COVID-19 pandemic (March 2020-May 2021).
303 procedures were analysed: 77 pronation manoeuvres out of 156 (49.3%) and 82 supination out of 147 (55.8%) were performed in dedicated time slots in the afternoon (15.30-19.00) and in the morning (9.30-12.30) shifts, when the nursing staff was increased. At least five healthcare providers performed pronation manoeuvres. Six device displacements were registered.
Planning complex activities such as prone positioning needs an effective strategy to optimize nursing staff workload in the intensive care unit. This organization allowed to perform pronation cycles with a duration of at least 16 h, according to current clinical recommendations.
俯卧位摆放是一项复杂且耗时的任务，需要重症监护病房的大量工作人员参与。新型冠状病毒肺炎疫情期间工作量增加以及人员配备减少，加重了重症监护病房护士的负担，这可能会对患者的安全和预后产生负面影响。
进行回顾性病历审查，分析新型冠状病毒肺炎疫情第一波和第二波期间（2020年3月至2021年5月）机械通气的重症患者俯卧位和仰卧位操作的小时分布情况。
共分析了303例操作：156例中有77例俯卧位操作（49.3%），147例中有82例仰卧位操作（55.8%）是在下午（15:30 - 19:00）和上午（9:30 - 12:30）班次护理人员增加的专门时间段内进行的。至少有五名医护人员进行俯卧位操作。记录到六次设备移位。
规划诸如俯卧位摆放等复杂活动需要有效的策略来优化重症监护病房的护理人员工作量。根据当前临床建议，这种安排使得能够进行持续时间至少为16小时的俯卧位循环操作。
