Nurse Perspectives on Prone Positioning for ARDS Patient in the ICU: A Qualitative Phenomenological Study of Facilitator and Barrier.

IF 2.5 Q2 NURSING
SAGE Open Nursing Pub Date : 2025-08-25 eCollection Date: 2025-01-01 DOI:10.1177/23779608251371102
Sriyono Sriyono, Hakim Zulkarnain, Erna Dwi Wahyuni, Jujuk Proboningsih, Wikan Purwihantoro, Maria-Pilar Mosteiro-Diaz
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引用次数: 0

Abstract

Introduction: Prone positioning is an established therapeutic intervention for acute respiratory distress syndrome (ARDS) patients. However, its utilization in ARDS treatment remains low, despite recommendations and evidence of its benefits.

Objective: This study aims to explore the phenomenon of performing prone position for ARDS patients in the intensive care unit (ICU), especially from the nurses' perspective of the facilitators and the barrier.

Methods: A qualitative phenomenological approach was employed. Fifteen ICU nurses from a referral hospital in Surabaya, Indonesia, who had performed at least 10 prone positions on intubated patients, were interviewed. Thematic analysis was conducted to identify emerging themes.

Results: The facilitator factors are the availability of specially designed tool, the knowledge about benefit for the patient, and the availability of plan to mitigate complication. The barrier factors are the heavy maneuver during the process, the needs of lots of manpower, and the agitating patient. The facilitators lead the nurse to following way, the availability of specialized design tools enhances nurse confidence and patient safety. Then, the knowledge related to prone positioning benefit reinforced prone position importance. Additionally, a planning and proactive measures are necessary since the prone positioning is posed risk. The barrier holds the nurse performance in the following way: the physical demand may lead to musculoskeletal problems, such as back pain; inadequate staffing results in procedure delays or cancellations. Patient agitation, especially in intubated and mechanically ventilated patients, posed additional challenges, including the risk of extubating and increased congestion.

Conclusion: ICU setting needs to be supportive to promote safe and effective prone positioning practices. This can be achieved through addressing the facilitator and the barrier of prone position. Additionally, prone positioning guideline development should involve the nurse.

Abstract Image

Abstract Image

护士对ICU中ARDS患者俯卧位的看法:促进和障碍的定性现象学研究。
简介:俯卧位是急性呼吸窘迫综合征(ARDS)患者公认的治疗干预措施。然而,尽管有推荐和证据表明其有益,但其在ARDS治疗中的使用率仍然很低。目的:本研究旨在探讨重症监护室(ICU) ARDS患者实施俯卧位的现象,特别是从护士的促进者和障碍者的角度进行探讨。方法:采用定性现象学方法。对印度尼西亚泗水一家转诊医院的15名ICU护士进行了访谈,这些护士对插管患者进行了至少10次俯卧位。进行了专题分析,以确定新出现的主题。结果:辅助因素为:是否有专门设计的工具、对患者获益的认识、是否有减轻并发症的计划。障碍因素是手术过程中机动较大、需要大量人力、患者情绪激动等。辅导员引导护士遵循以下方式,专业设计工具的可用性增强了护士的信心和患者的安全。然后,俯卧位益处相关知识强化了俯卧位的重要性。此外,由于俯卧姿势会带来风险,因此计划和主动措施是必要的。障碍以以下方式阻碍护士的表现:身体需求可能导致肌肉骨骼问题,如背部疼痛;人手不足导致程序延误或取消。患者的躁动,特别是在插管和机械通气患者中,带来了额外的挑战,包括拔管和增加堵塞的风险。结论:ICU环境需要支持,以促进安全有效的俯卧位做法。这可以通过解决促进者和俯卧位的障碍来实现。此外,俯卧位指南的制定应包括护士。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.10
自引率
5.00%
发文量
106
审稿时长
15 weeks
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