Protecting patients’ skin during prone ventilation - the PRONEtect practice guidance document

Background Ventilating the critically ill patient with acute respiratory distress syndrome in the prone position is a lifesaving strategy, but it is coupled with adverse consequences such as the development of pressure ulcers. Aim To develop evidence-based recommendations for critical care clinicians in a concise, simple and visual practice guidance document. Methods A gap analysis study conducted by the Skin Integrity Research Group and the Swedish Centre for Skin and Wound Research (currently submitted to a peer-reviewed international journal) formed the basis for the practice guidance document. The gap analysis study reviewed which guidelines, equipment/devices and other digital resources were available during a systemic, comprehensive literature and digital search conducted between August and November 2020. An international expert panel reviewed the identified gaps and provided their feedback. The information from the comprehensive search provided the foundation for the design of the practice guidance document. Findings The “PRONEtect (Prone & Protect) practice guidance document – skin care considerations for the patient in the prone position” was developed by the research team, reviewed and approved by the expert panel and then launched on public platforms in December 2020. Conclusions The PRONEtect document’s recommendations could assist clinicians in reviewing key considerations for tissue damage prevention in patients in the prone position.