Organisation and delivery of a dedicated multidisciplinary prone ventilation team in the intensive care unit: Strategies and lessons from COVID-19

• Published in: PloS one 2023-12, Vol.18 (12), p.e0296379-e0296379
• Main Authors: Bracegirdle, Luke, Stubbs, Matthew, Rahman, Rezaur, Jackson, Alexander I R, Burton-Papp, Helmi C, Chambers, Robert, Gupta, Sanjay, Grocott, Michael P W, Dushianthan, Ahilanandan
• Format: Article
• Language: English
• Subjects: Coronaviruses; COVID-19; COVID-19 - epidemiology; Critical care; Delivery of Health Care; Engineering and Technology; Evaluation; Health aspects; Health care industry; Hospitals; Humans; Hypoxia; Intensive care; Intensive Care Units; Leadership; Management; Mechanical ventilation; Medicine and Health Sciences; Mortality; Nursing; Pandemics; Patient positioning; Patients; People and Places; Personal protective equipment; Prone Position; Public health administration; R&D; Research & development; Research and Analysis Methods; Respiration, Artificial; Safety and security measures; SARS-CoV-2; Teams; Theater; Ventilation; Ventilators; Well being; Workforce planning
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0296379

COVID-19 placed immense strain on healthcare systems, necessitating innovative responses to the surge of critically ill patients, particularly those requiring mechanical ventilation. In this report, we detail the establishment of a dedicated critical care prone positioning team at University Hospital Southampton in response to escalating demand for prone positioning during the initial wave of the pandemic. The formation of a prone positioning team involved meticulous planning and collaboration across disciplines to ensure safe and efficient manoeuvrers. A comprehensive training strategy, aligned with national guidelines, was implemented for approximately 550 staff members from a diverse background. We surveyed team members to gain insight to the lived experience. A total of 78 full-time team members were recruited and successfully executed over 1200 manoeuvres over an eight-week period. Our survey suggests the majority felt valued and expressed pride and willingness to participate again should the need arise. The rapid establishment and deployment of a dedicated prone positioning team may have contributed to both patient care and staff well-being. We provide insight and lessons that may be of value for future respiratory pandemics. Future work should explore objective clinical outcomes and long-term sustainability of such services.