Q: What is the current science on prone positioning and what are the nursing implications?

A: Pol-Andre Senecal, msn, np, cns, acnp, ccns, replies:

This is a very timely question as recent changes in the evidence supporting prone therapy have the potential to radically change the approach to patients with severe acute respiratory distress syndrome (ARDS). Positioning patients face-down in a prone position was first studied as a method to improve oxygenation in patients with acute respiratory failure in the mid-1970s.1,2  Subsequent studies of prone positioning continued to demonstrate improved oxygenation in patients, but the impact on survival remained disappointing3,4  and the intervention remained a rescue therapy to be used only when more conventional approaches failed and the patient’s condition was deteriorating.5 

The wisdom on prone therapy changed in 2013 when a team of researchers in Europe published...

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