Members of the ICU and Respiratory Therapy teams at Penn Medicine Lancaster General Hospital.
Team Approach Enhances Safety and Efficiency of Life-Saving Program
Nurse anesthetists and surgical techs at Penn Medicine Lancaster General Hospital recently joined the team of ICU nurses and respiratory therapists performing pronation therapy on critically ill COVID-19 patients in the ICU and Neuro/Trauma Unit.
Proning is for patients with acute respiratory distress syndrome (ARDS) and involves placing the patient on their stomach for 12–16 hours to better oxygenate the lungs. It requires a team of providers working in sync to ensure the patient is safely positioned — in order to prevent pressure sores and protect the airway. Patients are later supinated, or placed on their backs, once again.
"Most of these patients are on ventilators or have IV or central lines, tubes and drains that must remain intact," said Bill Burger, CRNA, nurse anesthesia manager.
At the start of the pandemic in the spring, when elective surgeries were paused, operating room staff assisted with proning in the ICU. As operations resumed, ICU and Respiratory Therapy staff maintained responsibility for proning and supinating patients. With the recent increase in COVID-19 admissions in late fall, the nurse anesthesia team stepped in to help.
"Our team has been challenged like never before, but the selfless support of our colleagues has given us the lift we needed to rise to the occasion," said Matthew Pavlichko, MS, RRT-NPS, director, Respiratory Care and Pulmonary Diagnostics.
The proning team comes together twice a day to turn all patients with orders for pronation therapy. They coordinate their timing with X-ray technicians, who then scan each patient to confirm that all tubes and lines are in place.
"This is a true collaboration of all teams to make a labor-intensive procedure as efficient and safe as possible," said Aimee Anderson, MSN, RN, CCRN, ICU nurse manager.