Study: COVID-19 Patients at Risk for Pressure Injuries When Prone

A new study centers on reducing pressure injury risk for COVID-19 patients lying in a prone position.

Published on Sept. 13, 2021, by the American Journal of Critical Care, the study examined the impact of including a certified wound and skin care nurse on the healthcare team that treats patients diagnosed with COVID-19.

Research focused on patients being treated for Acute Respiratory Distress Syndrome (ARDS), who are typically placed in a prone position “to improve oxygenation and reduce mortality risk,” the study said.

Two groups of patients were compared: Those whose medical teams included a certified wound and skin care nurse, and those patients whose medical teams did not include a nurse with that specialty.

The study concluded that patients in the intervention group — the group whose healthcare team included that wound care nurse — “had a 97-percent lower adjusted odds ratio of a pressure injury developing than did patients in the comparison group.

“The results of the analysis showed lower mortality in patients placed prone for longer than 12 hours. However, the results also showed higher-than-normal rates of pressure injuries the longer a patient was placed prone.”

Researchers also noted that other studies “have reported the development of new pressure injuries in patients with ARDS who are placed prone.” The most common sites of pressure injuries, this study said, are the face, cheekbones, thorax, and over bony prominences.

The study described the extensive preparations and expertise needed to turn a critically ill patient from the more traditional supine position to a prone position, noting, “In total, we determined that 10 people with specific and specialized expertise were needed to successfully place a critically ill patient prone and avoid the complications well established in the literature.”

In turning patients into prone position, medical personnel take a number of precautionary steps to avoid shear and to protect each patient’s skin… thus the high number of specialists who need to be involved.


About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at

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