A nurse co-authors an article on evidence-based guidelines for the implementation of awake self-prone positioning (ASPP) for COVID-19 patients. The National Black Nurses Association (NBNA) announces newly elected officers, board members, and nominations committee members. A podcast focuses on the challenges nurses have faced during the pandemic. Read on for more nursing news and insights.
Nurse co-authors important article on COVID-19 treatment guidelines
Erin Hare, MSN, CCRN, a nurse on staff at Delaware-based ChristianaCare, has co-authored an article on an initiative that has led to the development of evidence-based guidelines for the implementation of awake self-prone positioning (ASPP) for COVID-19 patients.
The article,“Awake Self-Prone Positioning: Implementation During the COVID-19 Pandemic,” details how ChristianaCare developed guidelines for ASPP during the early days of the pandemic and appears in a new issue of Critical Care Nurse with an accompanying sample of the ASPP education materials. The ASPP guideline has now become an established part of caring for patients with COVID-19 throughout the health system.
According to the American Association of Critical-Care Nurses (AACN), ASPP involves nonintubated patients turning themselves with minimal assistance, while they receive supplemental oxygen through a high-flow nasal cannula or noninvasive ventilation. As the pandemic has progressed, ASPP has been increasingly used for COVID-19 patients with early signs of respiratory failure as a therapeutic modality that could potentially improve outcomes, would do no harm, and could be provided safely in ICUs and other units.
Hare is a nursing professional development specialist for the medical ICU and rapid response teams (RRTs) at ChristianaCare’s Christiana Hospital. “At ChristianaCare, we seek new knowledge, and we continually look for ways to innovate,” Hare said in a prepared statement. “As the COVID-19 pandemic spread, we recognized how we could adapt awake self-prone positioning to help improve the outcomes of our patients. We also quickly developed policies, procedures, and education to advance this treatment to our entire health system, so more patients could benefit.”
From March 18, 2020, when the first patient with COVID-19 was admitted to ChristianaCare, through Aug. 5, 2020, the hospital had 1,000 COVID-19-related patients admitted. Of these, 272 patients received a high-flow nasal cannula, with 111 having documentation of ASPP.
Initially, nurses in the MICU were the first to start implementing the ASPP intervention in patients with COVID-19, during RRT calls and proactive patient rounds. As the number of patients with COVID-19 grew between March and June, the rate of RRT calls from the COVID-19 units increased approximately 40 percent.
The RRT nurses worked closely with unit charge nurses and intermediate-care nurses to introduce ASPP and help them implement the new process with patients. But as the number of patients with COVID-19 increased in ICUs and non-ICU areas, ASPP recommendations and implementation began to vary, and more questions about the procedure arose.
Nursing professional development specialists and clinical nurse specialists moved quickly to expedite the development of standardized clinical education and clear, concise, evidence-based instructions and considerations that team members could easily apply at the bedside. The clinical education plan included didactic learning followed by hands-on demonstration of ASPP, as well as where and how to document the patient’s position in the electronic medical record.
Patient education is a crucial component of ASPP, and patients who are generally asymptomatic early during the course of the disease may not understand how quickly respiratory distress can arise and become serious. The urgency and importance of protecting their lung function can seem excessive while their symptoms are seemingly minor.
Nurses use multiple educational methods to meet the learning needs of each patient, including video conversations via tablets and written materials. Interpreters are also available via the tablets, and all printed materials are made available in English and Spanish.
Outcome data specific to this intervention is limited, but initial findings are positive, according to the AACN. The ASPP guideline has become an established part of caring for patients with COVID-19 and is fully integrated into practice in units caring for them.
Stay up-to-date on COVID-19. Explore essential learning for nurses.
NBNA elects new officers, other constituents
Officials with the National Black Nurses Association (NBNA) have announced newly elected officers, board members, and nominations committee members.
Officers include Martha A. Dawson, DNP, RN, FACHE, associate professor, University of Alabama at Birmingham, School of Nursing, Birmingham, AL – president and chief executive officer (CEO, re-elected); Sasha DuBois, MSN, RN, nurse administrator, Brigham and Women’s Hospital, Boston, MA – secretary (re-elected); Lovene Knight, PhD, RN, retired – parliamentarian; Cynthia Bell, MSN, BSN, RN, retired, nurse manager/assistant chief, Homeless and Mental Health Residential, Rehabilitation Treatment Center Louis Stokes Cleveland Veterans Medical Center, Cleveland, OH.
Board of directors include Kim Cartwright, LPN, account manager, Medstar Visiting Nurse Association, Clinton, MD; Mary Kelly, DNP, MSN, MHA, NEA-BC, senior director, cancer center and infusion services, University Medical Center New Orleans (LA); Angelo Moore, PhD, RN, NE-BC, program manager, Duke Cancer Institute, Office of Health Equity, Chapel Hill, NC; Ardenia Norris, student representative, Auburn University at Montgomery (AL).
New nominating committee members include Joni Lovelace, RN, BS, CCM, CNC, president and CEO, Lovelace Multi-Care Health Services, LLC, Atlanta, GA, and Vaple I. Robinson, PhD, RN, MSL, CHES, associate professor, Coppin State University, Helene Fuld School of Nursing, Baltimore, MD.
Explore essentials of nursing leadership in our in-depth series: Leadership and Nursing Practice Specialty.
Podcast spotlight: Pandemic Ethics Podcast with Nurse Beth
As a feature of the Pandemic Ethics Podcast, this conversation between Nurse Beth Hawkes and Joshua Preiss, director of philosophy, politics, and economics at Minnesota State University, focuses on the challenges nurses have faced during the pandemic.
Preiss and Nurse Beth also consider whether nurses’ values, concerns, and expertise have been taken seriously, and ask what practices or policies can make it easier (or harder) for nurses to continue to perform their essential work effectively. The Pandemic Ethics Podcast covers discussions of the defining ethical challenges of the pandemic, featuring experts in ethics, public health, law, economics, public policy, and beyond.
This recording and others are available at pandemic-ethics.com.
Views expressed here are those of the author and do not necessarily represent the views of Elite Learning or Colibri Group. Media referenced in this news round-up does not constitute an endorsement.