The Development of Clinical Nursing Practice Guidelines for the Prevention of Complications from Prone Position in Patients with Acute Respiratory Distress Syndrome, Rajavithi Hospital

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Boonchuen Aimmak
Patitta Nuekwen
Sunitsa Khanacharoen
Thanida Homjeen


The purpose of this research and development was to develop a clinical nursing practice guidelines (CNPG) for the prevention of prone complications in patients with acute respiratory distress syndrome (ARDS). This study consisted of 3 phases: 1) situational analysis 2) develop guidelines based on the Soukup Model (2000) and 3) evaluate the use of guidelines. Implementing CNPG with the Deming Cycle; PDCA was studied in intensive care and semi-critical wards from December 2021 to April 2022. The samples composed of 1) 40 registered nurses and 2) 10 ARDS patients. The study was found that 1. CNPG for preventing complications from prone position of ARDS patients consisted of 4 phases: 1) pre-prone position care 2) nursing care for prone position 3) nursing care during prone position 4) Post-prone position care 2. The results of using the CNPG found that nurses had higher scores on knowledge and clinical skills, as well as a high level of satisfaction with using the guidelines, 88.7 % of guidelines were followed and found to have decreased incidence of pressure injuries in a prone position and no endotracheal tube displacement. However, the CNPG should be monitored and reviewed regular continuously.

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Aimmak, B., Nuekwen, P., Khanacharoen, S., & Homjeen, T. (2022). The Development of Clinical Nursing Practice Guidelines for the Prevention of Complications from Prone Position in Patients with Acute Respiratory Distress Syndrome, Rajavithi Hospital. Vajira Nursing Journal, 24(1), 51–66. Retrieved from
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