Proning for COVID-19 Patients: A Task-Shifting Feasibility Study

Area of Science:

• Critical Care Medicine
• Healthcare Management
• Infectious Disease Epidemiology

Background:

• The COVID-19 pandemic created critical shortages of healthcare workers (HCW), particularly in intensive care units (ICUs).
• Complex interventions like proning for acute respiratory distress syndrome (ARDS) were significantly impacted by HCW limitations.
• A need for innovative staffing solutions emerged to maintain patient care standards during the crisis.

Purpose of the Study:

• To implement and evaluate a task-shifting initiative for proning patients with COVID-19-related ARDS.
• To assess the effectiveness of training non-ICU HCW to perform proning procedures.
• To enhance teamwork and communication during critical care interventions.

Main Methods:

• A training program was developed and delivered to 33 HCW from diverse departments.
• Participants were trained in the safe execution of the proning procedure for ARDS patients.
• An interdisciplinary team subsequently performed proning on 90 patients with COVID-19-related ARDS.

Main Results:

• Trained HCW reported feeling adequately skilled to safely prone patients.
• The initiative facilitated multiple proning sessions for 90 ARDS patients.
• Participants demonstrated increased awareness of the benefits of proning.

Conclusions:

• Task-shifting for proning is a viable strategy to address HCW shortages in ICUs during pandemics.
• Interdisciplinary training enhances HCW confidence and competence in performing complex procedures.
• Effective teamwork and communication are crucial for the safe and successful implementation of proning.