Holistic care for patients with severe coronavirus disease 2019: An expert consensus.
Hui Wang, Tieying Zeng, Xinjuan Wu and 1 others
PMID 32292634WHAT IT FOUND
Nursing care for severe or critical COVID-19 should use level II protection in isolation wards, level III for aerosol procedures, and bundles for oxygen, prone positioning, skin, nutrition, infection control, psychological support and discharge.
Key findings
01The consensus applies to patients with severe or critical COVID-19 and was developed by 22 nursing experts, one medical expert and one hospital infection control expert from 20 hospitals across China.
02Nurses should use level II protection in isolation wards and level III protection for aerosol-producing procedures such as sputum aspiration, tracheal intubation, noninvasive ventilation, tracheotomy and cardiopulmonary resuscitation.
03The care bundles recommend prone ventilation for more than 12 hours per day when the PaO2/FiO2 ratio is continuously lower than 150 mmHg, with regular side-to-side position changes and decompression dressings for pressured areas.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It is an expert consensus, not a trial or systematic review, so it does not show that the recommended care improves outcomes. No patients were studied and no outcomes were measured. The recommendations were based on protocols, literature and frontline experience, not on a transparent search or quality appraisal. It is specific to severe or critical COVID-19 in China during the early outbreak and may not fit other settings.
Declared interests
The paper reports no funding and no competing interests.
The easy way to misread this
Do not read these recommendations as evidence that the care bundles improve outcomes. The paper is an expert consensus without enrolled patients or measured results.