Evidence-Based Nusing Innovations: Original ArticlesProne Positioning Is It Safe and Effective?Dirkes, Susan RN, MSA, CCRN; Dickinson, Sharon RN, MSN, CNS-BC, ANP, CCRN; Havey, Renee RN, BSN, CCRN; O'Brien, Denise RN, ACNS-BC, FAANAuthor Information Surgical Intensive Care and Progressive Care (Ms Dirkes), Surgical Intensive Care and Rapid Response (Ms Dickinson), and Surgical Intensive Care (Ms Havey), University of Michigan; University of Michigan School of Nursing (Mss Dickinson and O'Brien); and University of Michigan Hospitals and Health Centers, Ann Arbor (Ms O'Brien). Correspondence: Sharon Dickinson, RN, MSN, CNS-BC, ANP, CCRN, University of Michigan Surgical Intensive Care/Rapid Response, University of Michigan Hospital and Heath Centers, Box 0076, 1500 E Medical Center Dr, Ann Arbor, MI 48176 ([email protected]). Mss Dirkes and Dickinson share first authorship. The authors thank Craig Meldrum for his assistance in gathering the data for evaluating their prone positioning protocol. They also thank the staff of the Surgical Intensive Care Unit who have made the prone protocol initiative safe and effective for the patients. The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. Critical Care Nursing Quarterly: January/March 2012 - Volume 35 - Issue 1 - p 64-75 doi: 10.1097/CNQ.0b013e31823b20c6 Buy Metrics Abstract Prone positioning has been used as a treatment option for patients with acute lung injury or acute respiratory distress syndrome (ARDS) since the early 1970s. Prone position and extended prone position ventilation have been shown to increase end-expiratory lung volume, alveolar recruitment, and oxygenation in patients with severe hypoxemic and acute respiratory failure. Prone positioning is not a benign procedure, and there are potential risks (complications) that can occur to both the patient and the health care worker. Notable complications that can arise include: unplanned extubation, lines pulled, tubes kinked, and back and other injuries to personnel. Prone positioning is a viable, inexpensive therapy for the treatment of severe ARDS. This maneuver consistently improves systemic oxygenation in 70% to 80% of patients with ARDS. With the utilization of a standardized protocol and a trained and dedicated critical care staff, prone positioning can be performed safely. © 2012 Lippincott Williams & Wilkins, Inc.