Buy this Article for $10.95

Have a coupon or promotional code? Enter it here:

When you buy this you'll get access to the ePub version, a downloadable PDF, and the ability to print the full article.


  1. Francisco, Mary Ann MSN, APN, AGCNS-BC, CCRN-K
  2. Pierce, Nicole L. PhD, RN
  3. Ely, Elizabeth PhD, RN
  4. Cerasale, Matthew T. MD, MPH
  5. Anderson, Daniela MD
  6. Pavkovich, David MD, FACP, FAAP
  7. Puello, Frances MD
  8. Tummala, Sandeep MD
  9. Tyker, Albina MD
  10. D'Souza, Felicia R. MD


Background: Proning intubated intensive care unit patients for the management of acute respiratory distress syndrome is an accepted standard of practice. We examined the nursing climate in 4 units and its impact on implementing a novel self-proning protocol to treat COVID-19 patients outside the intensive care unit.


Local Problem: Nursing units previously designated for medical/surgical populations had to adjust quickly to provide evidence-based care for COVID-19 patients attempting self-proning.


Methods: Nurses from 4 nursing units were surveyed about the implementation process on the self-proning protocol. Their perception of unit implementation was assessed via the Implementation Climate Scale.


Interventions: A new self-proning nursing protocol was implemented outside the intensive care unit.


Results: Consistent education on the protocol, belief in the effectiveness of the intervention, and a strong unit-based climate of evidence-based practice contributed to greater implementation of the protocol.


Conclusions: Implementation of a new nursing protocol is possible with strong unit-based support, even during a pandemic.