Don’t Delay!!!

By Allison Varnum

I recently presented Turn University’s Turning Patients Toward Positive Outcomes at an AACN meeting. This lecture is heavily focused on acute respiratory distress syndrome (ARDS). We discussed ARDS epidemiology, evidence-based treatments, variables related to improving outcomes, and the physiology and evidence of prone positioning. Prior to the lecture, I was getting pushback from a hospital administrator on using the PronovaO₂^TM. I asked him if he would stay for the lecture and then let me show him the PronovaO₂^TM afterwards. He looked at his watch, sighed, and said he would try to stay.

At the conclusion of the presentation, there were excellent questions from the audience. One of the best questions I was asked was “why doesn’t prone positioning work for my patients?” Imagine my surprise (and momentary horror) when the administrator with whom I had been talking before the lecture stood up before I could even start to follow up on this question. He immediately referred to the presentation and how important it is to recognize ARDS and intervene early! He excitedly sought out the nurse directors and managers in the room and asked how the hospital could help recognize ARDS earlier and implement the international guidelines regarding the timing of prone positioning. After I picked my jaw up off the floor, I offered resources to them and then watched as he ran to the front for the demonstration.

This is why I do this job – I sincerely want to improve outcomes for patients! There is a mountain of evidence regarding prone positioning for ARDS, but unfortunately, the standards of care are not always practiced. In 2013, the Proseva trial showed that EARLY prone positioning (within 36 hours of intubation) at a minimum of 16 hours per day was found to decrease mortality by 50% in patients at 28 days and 42% at 90 days¹. Why are we waiting to prone our patients? Perhaps it’s because 40% of ARDS cases are not even diagnosed and two-thirds of cases are a delayed diagnosis². We, as clinicians, must do better. This is why I am passionate about education and why I love to present our Turn University lectures to my colleagues who are in the trenches taking care of critically ill patients. By providing resources and education, I get to join in revolutionizing healthcare for patients.

Discover Turn University—our evidence-based educational platform accredited by the AACN. Our clinicians deliver the expertise you need to identify critical illnesses earlier as well as a non-biased review of interventions and best practices for positive patient outcomes. Visit us at turnmedical.com to explore our list of available courses and contact us to get one scheduled for your team this year.