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awake self-prone, COVID-19, multidisciplinary team



  1. Kapoor, Rajat MD, MBA
  2. Rader, Tiffany MSN, RN, AGCNS-BC, CMSRN
  3. Dillon, Jill MSN, RN, ACNS-BC, CCRN
  4. Jaydev, FNU MD
  5. Horvath, Dawn MSN, RN, ACNS-BC, CNS-BC
  6. Little, Aubrey PT, DPT
  7. Vickery, Jessica MSN, RN, AGCNS-BC
  8. DiPerna, Christen PT, DPT
  9. Brittain, Lynne PT, DPT, CCS
  10. Rahman, Omar MD


Purpose/Aims: Healthcare workers internationally continue to look for innovative ways to improve patient outcomes and optimize resource utilization during the coronavirus disease 2019 (COVID-19) pandemic. Proning awake, nonintubated patients has been suggested as a potential intervention in critical care. The aim of this study is to provide a multidisciplinary approach to safely perform awake self-prone positioning in the acute care setting.


Design: This is a prospective, descriptive study.


Method: Patients with COVID-19 were screened and enrolled within 48 hours of a positive test. After approval from the primary team, patients were provided education materials by a multidisciplinary team on the self-prone intervention. Visual cues were placed in the room. Patients were requested to maintain a diary of hours of prone positioning. Patients' baseline characteristics, admission vitals, daily oxygen requirements, and level of care were collected.


Results: Of 203 patients screened, 31 were enrolled. No pressure-related injury or catheter (intravenous or urinary) displacement was identified. Eighty-one percent of patients spent less than 8 hours a day in prone positioning. Among patients enrolled, none required invasive ventilation or died.


Conclusions: Awake self-proning can be performed safely in patients given a diagnosis of COVID-19 in the acute care setting with a multidisciplinary team.