From January 2013 to October 2015, the nursing team of the Department of Critical Care Medicine provided nearly 40,000 hours of Prone Position Ventilation (PPV) treatment for about 600 serious ARDS patients. A new nursing strategy, including nurse-guided sedation and analgesia, scientific choice of mattress, improved skin care and refined line fixing, has brought longer endurance of PPV treatment, effectively reduced the 28-day mortality, reduced the occurrence of third-stage bedsore to zero and ensured zero line slip. The team has therefore won the second prize of PUMCH 2015 nursing achievements.

Patients who need PPV pose nursing challenges as they usually feature particularly heavy weight, multiple lines inlaid, special operations and early post-operative stage.

Under the new strategy, before PPV, skin of the pressure part is cleaned and applied protective film, silastic foam dressing and polymer mattress is used; in turning a patient over, the body is raised 40cm above the bed to avoid friction with mattress; the head position is changed and limbs exercised regularly. For every two hours the patient is lifted above bed to relieve pressured parts and at the same time sweats on chest and belly are cleaned. These measures effectively prevented the most commonly seen skin damage in PPV and reduced the occurrence of bedsore. Individually tailored plans are made in the choice of mattress and line fixing. Nurse-guided sedation and analgesia is another feature of the critical care in our hospital. For every four hours, the leading nurse will make an assessment to decide the precise degree of sedation and analgesia to reduce patient's discomfort.