HCA TriStar Division: Lessons from COVID-19

HCA Healthcare | TriStar Division

Lessons from COVID-19: Practices to Prevent Healthcare-Associated Infections

HCA Healthcare, TriStar Division developed an Infection Prevention (IP) guidance for patients who require prone positioning. The guidance includes specific actions to take pre-proning, intra-proning, and post-proning. The health system acknowledges that obtaining venous access for patients who require prone positioning can be technically challenging and can present significant safety concerns.

To promote patient safety, the system requires the following:

  • Determine the need for a central venous access (CVC).
  • If CVC is necessitated, determine the feasibility of positioning the patient in a supine position to perform the procedure.
  • Place a peripherally inserted central catheter (PICC) instead of an internal jugular vein (IJ)/SCL.
  • If it is not possible to use a PICC or use a supine positioning, then a central venous catheter can be inserted with the patient in the prone position.
  • In all cases, ultrasound guidance must be used for choosing, puncturing, and cannulating the vein.


Special thanks to Darcy Koch, Division Lead IP for sharing this story and guidance with TCPS. For questions about how to adapt this guidance for your facility use, contact Lizzy Adeyemi.