关键词: 急性呼吸窘迫综合证, 清醒俯卧位, 成人, 专家共识, 护理

Abstract:

Objective To compile an expert consensus on prone position nursing for conscious adult patients with acute respiratory distress syndrom（here in after referred to as the “consensus”），aiming to promote and standardize the implementation of awake prone position in hospitals at different levels. Methods The first draft of the consensus was formed by reviewing existing literature，conducting clinical stakeholder interviews and expert meetings，followed by 2 rounds of expert correspondence，and recommendations were revised based on expert opinions，and the evidence and recommendation levels were scientifically graded. Results After 2 rounds of consultations with 20 experts，the recommendations were finally formed. The effective return rate of the questionnaire was 100%，and the expert authority coefficient was 0.90. In the first round of consultation，the frequency of full marks for necessity is 95%~100%，and the coefficient of variation of recommendation approval degree is 0~0.227. In the second round，the average value of the degree of approval rating has increased，ranging from 4.65 to 5.00，and the frequency of full marks for necessity is 100%，and the coefficient of variation is 0~0.201. The Kendall W coefficients of the 2 rounds of inquiry were 0.136 and 0.168，and the difference was statistically significant（P<0.05）. The consensus includes the formation of multidisciplinary teams，nursing evaluation，implementation key points，monitoring and management，health education，prevention of adverse events，management of special populations on the obesity people，and nursing quality indicators. Conclusion This consensus combines the existing evidence，clinical needs and the recommendations of medical and nursing experts，and it can provide guidance for patients to carry out conscious prone position as early as possible.

Key words: Acute Respiratorg Distress Syndrome, Awake Prone Position, Adult, Expert Consensus, Nursing