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

摘要：

目的 编写“成人急性呼吸窘迫综合征患者清醒俯卧位护理专家共识”（以下简称“共识”），旨在不同层级医疗机构中规范和推广清醒俯卧位护理。 方法 2022年12月—2023年2月，研究者查阅国内外文献，开展利益相关者访谈、专家会议，形成共识初稿，进行2轮专家函询，结合专家建议修订推荐意见，并评定证据及推荐等级，形成共识。 结果 共邀请20名专家参与函询，经过2轮专家函询，最终形成推荐意见，问卷有效回收率为100%，专家权威系数为0.90，第1轮专家函询推荐意见认同度为4.20~4.95，必要性满分率为95%~100%，推荐意见认同度变异系数为0~0.227。第2轮专家函询推荐意见认同度为4.65~5.00，必要性满分率均为100%，推荐意见认同度变异系数为0~0.201。2轮函询肯德尔和谐系数分别为0.136、0.168，差异具有统计学意义（P<0.05）。共识包括操作性定义、多学科团队的组建、护理评估、实施要点、监测和管理、健康教育、不良事件的预防、护理质量管理。 结论 共识结合了现有证据、临床实际需求和医疗护理领域专家的推荐意见，可为护理工作者尽早有效开展患者清醒俯卧位提供指导依据。

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