Implementation and progression of a rehabilitation-based prone team during the COVID-19 surge

Lauren Miccile, PT, DPT, ATC
Department of Physical Medicine and Rehabilitation
Division of Infectious Diseases
Poster Overview

Prone positioning is when a patient is placed on their stomach to help their lungs breathe better. This has been shown to be an effective treatment for critically-ill patients with COVID-19. Physical therapists and occupational therapists, called the “Prone team”, helped to place critically-ill patients with COVID-19 into the prone position and back into the supine position (laying on their back) during the COVID-19 surge from April to May 2020.

Data was collected by the rehabilitation department over 7 weeks and was analyzed to see if the Prone team improved in efficiency based on the minutes spent in the room.

The Prone Team sought strategies for an improved process. They utilized therapists with experience working in intensive care units, provided their own prone positioning supplies and used a dedicated pager for easier scheduling. The results showed that the time spent in the room decreased from the first half to the second half of data collection. The time for placing a patient in prone took longer than placing a patient in supine. This suggests that the Prone team became more proficient and efficient because of the improvements they implemented.

 

Scientific Abstract

Introduction

Rehabilitation therapists (physical and occupational therapists) assisted in positioning patients with COVID-19 related ARDS into prone from April-May 2020.

 

Methods

Data was collected by the rehabilitation department over 7 weeks. The primary outcome of time spent in the room was analyzed in regard to phase, the position change and volume of events.

 

Results

The mean amount of time spent in the room was 24.33 mins (SD = 8.58) during the early phase and 19.41 mins (SD = 6.32) during the late phase. The mean amount of time spent in the room was 25.26 mins (SD = 8.90) for prone positioning and 19.37 mins (SD = 5.89) for supine positioning. The amount of time spent in the room per rehabilitation therapist was 8.34 mins (SD

= 3.11) during the early phase and 6.48 mins (SD = 2.11) during the late phase. All of the differences in time were statistically significant. There was no statistically significant difference in time spent in the room for events with varying numbers of rehabilitation therapists.

 

Discussion

The results indicate significant differences in time based on the task and improvement in efficiency. These changes are attributed to demands of the task, experience, program improvement and reduction in patient volume.

Clinical Implications
The data analysis shows that the time spent in the room decreased from the first half to the second half of data collection. This suggests that the Prone team became more proficient and efficient because of the improvements they implemented.
Research Areas
Authors
Lauren Miccile, Jillian Ng, Joseph Tolland
Principal Investigator
Lauren Miccile

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