(412) Prone Positioning Device Prototype Improves Provider Experience and Perception of Patient Safety

Introduction: Prone positioning improves clinical outcomes in ventilated intensive care unit (ICU) patients with acute respiratory distress syndrome. However, proning is labor and time-intensive with risk of dislodging critical lines or tubes limiting its use in clinical practice. We developed an inflatable proning device, which secures patients with their lines and tubes while providing a low-friction outer surface to rotate the patient to maximize control and minimize effort. We aim to evaluate whether users found our prototype beneficial.

Methods: We held three testing sessions for our prototype and invited ICU providers from an adult and a pediatric institution. Participants were asked to fill out a pre-survey to assess their experiences with patient proning. They then watched a video on the device and had hands-on demonstrations in the simulation suite. Afterwards, they were asked to fill out a post-survey to assess their experience with the device. Both surveys included likert-scale questions on a scale from 1-9 regarding force and safety, with higher numbers representing more force/risk.

Results: A total of 24 ICU providers participated. Of providers with experience in proning, providers cited “lines and tubes management, finding/coordinating appropriate staff, stopping of proning process, and provider injury” as challenges with existing proning practices, with 50% of providers responding that these disruptions occurred >40% of the time. When asked the amount of force required to prone a patient, the average response was 4.9 (SD=2) with prior experience compared to 1.8 (SD=0.8) with our device. When asked about safety concerns of the proning process, the average response was 4.3 (SD=1.8) with prior experience compared to 2.2 (SD=0.96) with our device. 22/22 (100%) respondents felt our device would improve provider proning experience. 21/22 (95.4%) would use our product, would recommend our product to other providers, and felt our device would improve patient care.

Conclusions: After testing our device, ICU providers reported decreased proning force required, increased patient safety, and improved overall proning experience. These results provide support for the continued development of this proning device and its potential implications in clinical practice.