The experiences of critical care nurses caring for patients undergoing awake prone positioning: a qualitative study

BACKGROUND: Awake prone positioning is increasingly used for patients with respiratory distress, and understanding the experiences of critical care nurses can illuminate insights into best practices, emotional and physical impacts on the caregivers, and potential areas for support and training improvements. This qualitative study aims to fill a gap in existing research by providing a deeper understanding of the nursing care involved in awake prone positioning from the frontline caregivers’ viewpoint. METHODS: A descriptive qualitative research design was employed to capture the rich and nuanced experiences of critical care nurses. Sixteen participants were purposively selected from seven intensive care units (ICUs) across four tertiary hospitals where awake prone positioning was routinely implemented. Semi-structured interviews were conducted. Content analysis was applied to extract key themes from the interview data. RESULTS: This study generated six main themes: (1) The role of nurse in APP Implementation, (2) Technical challenges in APP, (3) Team collaboration and communication, (4) Provision of patient psychological support, (5) Training and educational needs, and (6) Nurses’ Burden. These findings revealed that critical care nurses play a crucial role in the successful implementation of awake prone positioning, encountering significant technical challenges and requiring effective team collaboration and communication to ensure optimal patient care. Critical care nurses also provided psychological support to patients, addressing both emotional and physical responses to the procedure. Additionally, the findings highlighted the importance of ongoing training and education for critical care nurses to handle the demands of awake prone positioning, as well as the physical and emotional burdens faced by critical care nurses in this high-stress environment. CONCLUSION: This study sheds light on the intricate experiences of critical care nurses in awake prone positioning. By recognizing and addressing these aspects, we will contribute to an environment that not only optimizes patient care but also nurtures the well-being and resilience of the nursing workforce. Future research should further explore sociocultural influences and patient perspectives to refine interventions and elevate the standards of care in awake prone positioning. CLINICAL TRIAL NUMBER: Not applicable.