UNIVERSITY OF SANTO TOMAS – COLLEGE OF NURSING

Espana Boulevard, Sampaloc, Manila, Philippines 1015

Tel. No. 406-1611 loc.8241 | Telefax: 731-5738 | Website: www.ust.edu.ph

Name: SALAZAR, Nica Sharmaine C. RLE: 8.4

Yr.&Sec.: 4NUR8 Clinical Instructor: Ma’am Pagdilao

RESEARCH BIBLIOGRAPHY LEVEL IV

Title of the article:
Prone Positioning of Patients With Acute Respiratory Distress Syndrome
APA Format:
Drahnak, D. M., RN, DNP, CCNS, CCRN, & Cluster, N., RN, MS, CCRN-CSC. (2015). Prone
Positioning of Patients With Acute Respiratory Distress Syndrome. Critical Care Nurse,
36(6), 29-38. Retrieved November 29, 2018

Guide Questions:

1. Using the PICO format, formulate your questions:

a. What is the population of interest?
 The population of interest in the study are Patients suffering from Acute Respiratory
Distress Syndrome.
b. What is the intervention implemented or the interest?
 The intervention that was implemented in the study was supporting ARDS patient by
positioning him in prone position.
c. What is the comparison? Or the current applicable practice or status?
 In the Philippines, our current practice does not coincide with the study since we
would always suggest every client suffering from respiratory condition to sit in a semi
to high fowler’s position to facilitate lung expansion. However, the study gave us new
techniques and ideas to help our client in their breathing.
d. What is the outcome of interest?
 The purpose of this article is to provide education to the patient and the family and
even the health allied personnel like me.
2. Discuss your process of evidence research
a. Identify key words used
 Acute biologic crisis
 Respiratory failure
b. Identify data bases used
 Science direct
 Elsevier
c. Identify at least 5 potential articles relevant to your problem
Coppadoro, A., & Foti, G. (2018). Prone Positioning in Severe Acute Respiratory
Distress Syndrome. Oxford Medicine Online. doi:10.1093/med/9780190467654.003.0021
 Drahnak, D. M., RN, DNP, CCNS, CCRN, & Cluster, N., RN, MS, CCRN-CSC. (2015).
Prone Positioning of Patients With Acute Respiratory Distress Syndrome. Critical Care
Nurse, 36(6), 29-38. Retrieved November 29, 2018

Guérin, C. (2017). Prone Position. Acute Respiratory Distress Syndrome, 73-83.

doi:10.1007/978-3-319-41852-0_6

Morrell, N. (2010). Prone positioning in patients with acute respiratory distress

syndrome. Nursing Standard, 24(21), 42-45. doi:10.7748/ns.24.21.42.s53

Wong, A. H. (2013). Prone positioning in severe acute respiratory distress syndrome.

Thorax, 69(6), 579-579. doi:10.1136/thoraxjnl-2013-204441

d. Choose one article to appraise

Drahnak, D. M., RN, DNP, CCNS, CCRN, & Cluster, N., RN, MS, CCRN-CSC. (2015).
Prone Positioning of Patients With Acute Respiratory Distress Syndrome. Critical Care
Nurse, 36(6), 29-38. Retrieved November 29, 2018.

Acute respiratory distress syndrome (ARDS) is manifested acutely and

progresses rapidly. Interventions used supportively to decrease ventilator-induced lung
injury and to maximize oxygenation include lung-protective ventilation, use of positive
end-expiratory pressure, and fluid management to maintain cardiac output. Other
therapies used in combination with the measures noted may include inhaled pulmonary
vasodilators, partial liquid ventilation alternative ventilation, neuromuscular blocking
agents, exogenous surfactant, intravascular oxygenation, extracorporeal membrane
oxygenation, and prone ventilation. The purpose of this article is help health care
practitioners as well as the family in alleviating the condition of the client suffering from
ARDS and to provide Knowledge of the physiological benefits of prone therapy in select
ARDS patients. Practitioners resort to rescue therapies to improve oxygenation and
salvage the patient Nurses are primarily responsible for placing the patient prone and for
the on-going assessment of the patient. In-depth training and in-service training serve as
a foundation for the success of prone positioning. A variety of techniques or devices can
be employed to achieve prone position; namely, manual proning maneuvers, positioning
devices, and automated beds. The basis for initiating prone positioning begins with
assessment of the patient, a key activity of acute and critical care nurses The decision
regarding which technique or device to use is multifactorial and should take into
consideration facility resources, nurses’ education level, and equipment availability.

e. Assess the available evidence for its appropriateness and applicability for our practice

The study was supported by other studies which suggest that the importance of
early prone positioning and indicates that sufficient duration of prone positioning can
lead to better outcomes for patients. According to the Study, Interventions used
supportively to decrease ventilator-induced lung injury and to maximize oxygenation
 include lung-protective (low-tidal-volume) ventilation, use of PEEP, and fl uid
management to maintain cardiac output.

3. Give your general comment on the study identified

The study is very informative. it is indeed helpful in the nursing field in improving
the techniques and interventions that nurses carefully render. As we all know, ARDS is
manifested acutely and progresses rapidly. Recognition and treatment of the underlying
cause with on current mechanical ventilator support is the multimodal approach to
combat the damaging effects of the disease. As a means of supportive care for ARDS,
practitioners resort to rescue therapies to improve oxygenation and salvage the patient.
This research demonstrates the importance of early prone positioning and indicates that
sufficient duration of prone positioning can lead to better outcomes for patients. hence,
they concluded that Prone positioning of a patient with ARDS may result in a greater
proportion of alveoli being aerated at equivalent delivered volumes and should be
considered as an early supportive therapy rather than a rescue maneuver.

4. Give your recommendation for evidence-based practice

If I were to conduct another study regarding prone positioning, I would try to use
the intervention to everyone, including Pediatric and Geriatric Client so as to determine
the span and the inclusiveness of this intervention..