Pronation: a nursing technology that promotes wellbeing among covid-19 patients at general hospital dr. Manuel Gea Gonzalez, in Mexico City

Abstract

Problem: Does Pronation, a nursing technology, promote wellbeing in the care of COVID-19 patients at the General Hospital Dr. Manuel Gea González, in Mexico City? 

Objective: To analyze Pronation as a nursing technology and its promotion of COVID-19 patients’ wellbeing at the General Hospital Dr. Manuel Gea González, in Mexico City. 

Theoretical Framework: Pronation is a procedure used at the Intensive Care Unit with patients presenting Acute Respiratory Distress Syndrome (ARDS) with severe hypoxemia. Bibliographical references clearly support the application of this procedure due to the improvement it produces in oxygenation and the increased survival rate in patients. The main foundation behind this technology is that Ventral Decubitus (VD) promotes an improved redistribution of ventilation toward the dorsal regions of the lung, which are mainly collapsed during Dorsal Decubitus. Nursing staff have used this procedure because VD has proven to be a strategy with a useful and accessible impact over respiratory physiology.

Methodology: A nonexperimental, quantitative, cross-sectional, prolective, descriptive study to analyze Pronation, as a Nursing technology that promotes wellbeing in the care of COVID-19 patients at General Hospital Dr. Manuel Gea González, in Mexico City. Pronation as a Nursing technology was the variable being measured. The Universe was 530 Nursing professionals working at the Hospital. The population and sample were 52 Nursing specialists working with COVID-19 patients, representing 9.81% of the Universe.

Results: As for training and experience with Pronation, 50% of the staff consider they have received sufficient training in regards to the SARS-CoV-2 virus, but they are still under training. Additionally, 84.62% consider that Pronation promotes a remarkable recovery in the patients, with oxygen saturations between 80 to 100%; 71.16% believe that patients do show hemodynamic instability due to the position shift, but not in every case; and 80.77% consider they make sure their patients do not develop pressure ulcers, given that 65.39% practice patient hygiene and movement to prevent such ulcers.

Discussion: From the interviewed staff, 50.01% consider they have received sufficient training regarding COVID and the pronation of patients. This is consistent with Hernandez et al., who describe the need of a team trained specifically on the procedure, preferably comprised of Nurses specialized in Intensive Care. Likewise, 84.62% of staff members believe Pronation improves oxygen saturation in patients from 80% to 100%. This is contrasted with Barrantes and Vargas, who indicate that if Pronation does not result in 5% improvement in oxygen saturation, the patient must be returned to dorsal decubitus.

Conclusions: Ventilation in prone position is a pulmonary protective action used for over 30 years that produces an evident and continuous improvement in blood oxygenation and the respiratory physiology. Therefore, Nursing specialists caring for COVID-19 patients recommend its use.