Authors: (including presenting author): :
Tang LY(1), Cheng CL(1), Chun YK(1), Lo WP(1), Ng CP(1)
Affiliation: :
(1)Pamela Youde Nethersole Eastern Hospital Intensive Care Unit
Keyword 1: :
pressure injury
Keyword 3: :
prone ventilation
Introduction: :
Numerous studies have demonstrated that prone ventilation for more than 16 hours effectively improves oxygenation for patients with acute respiratory distress syndrome (ARDS); however, it frequently leads to pressure injuries (PI), particularly in the facial region.
Objectives: :
(1) To determine the location, incidence and severity of PI associated with prone ventilation; (2) To evaluate the effectiveness of the new care bundle on the incidence and the severity of the facial PI in patient undergone prone ventilation.
Methodology: :
A nine-month prospective clinical trial was conducted in the adult ICU at Pamela Youde Nethersole Eastern Hospital (January–September 2025). The control group (January–July) used standard prone practices with a foam headrest and air-inflated chest support, while the intervention group (July–September) adopted a new protocol with a gel headrest which allow regular head repositioning; pillow and bedding for tougher chest support. Related nursing education on the proper application of the new prone practice was provided during implementation. Data was collected by reviewing the patient’s skin and pressure injury record.
Result & Outcome: :
Results: From January 2025 to September 2025, the total number of prone cases were 38 in which 16 cases in control group and 22 cases in intervention group. In the control group, 7 of 16(43.75%) cases developed pressure injury. In which (5 of 16 cases) mostly stage 1 and 2 PI on chin, eyebrow, iliac crest and cheek. 2 of 16 (12.5%) cases developed chin deep tissue pressure injury (DTPI). In the intervention group, only 2 of 22 (9.09%) cases developed stage 1 and 2 PI on chin. No case developed DTPI. The Fisher-Freeman-Halton Exact test was used for statistic calculation. The p-value was 0.038, significant at p< 0.05. Conclusions: The location of PI related to prone were identified mainly facial area such as chin, eyebrow and cheek in which chin is the most vulnerable area. The implementation of the new prone practice with full compliance to new workflow could significantly decrease the incidence and severity of facial PI for patient in prone ventilation as the number of total PI and DTPI were reduced in the intervention group.
