The Development of an Evidence-Based Postoperative Nausea and Vomiting Protocol in the Perioperative Setting

8.00
Hdl Handle:
http://hdl.handle.net/10755/157086
Category:
Abstract
Type:
Presentation
Title:
The Development of an Evidence-Based Postoperative Nausea and Vomiting Protocol in the Perioperative Setting
Author(s):
Clark, Deborah; Marvin, Mary
Author Details:
Deborah Clark, OSF Saint Francis Medical Center, Peoria, Illinois, USA, email: debkc@msn.com; Mary Marvin
Abstract:
PURPOSE: Thirty percent of preoperative patients in general and up to 70% of patients at high risk suffer from postoperative nausea and vomiting (PONV). PONV can increase the patient's risk for aspiration, extended stay, increase financial burden to the patient and institution, increase the patient's discomfort, and decrease patient satisfaction. An evidence based protocol was developed to proactively promote a decrease or elimination of PONV in the perioperative setting. Description: A collaborative perioperative team was formed. After reviewing extensive literature of the patient at risk for developing PONV (including surgical procedures, treatment modalities, and patient demographics) a risk scoring tool was developed. Points were assigned preoperatively for 8 identified risk factors such as patient gender, smoking history, type of surgical procedure, anesthesia type, procedure duration, use of post-op opioids, previous history of motion sickness or prior incidence of PONV. For each risk factor level identified, prophylactic strategies were defined, both pharmacological and nonpharmacological, that could be implemented to benefit the patient for a positive outcome. A physician order set was created to include the risk factor level, intravenous hydration, and medications categorized by drug class for utilization during the perioperative time frame. Prior to initiation, the protocol was approved by multiple hospital committees. Once approval was achieved, a copy of the order set, and risk and prophylaxis table were placed on every patient's chart for utilization by the anesthesia provider and the rest of the perioperative team. EVALUATION: Through utilization of the evidence based protocol for PONV, patients were identified at risk for developing PONV and were treated prior to anesthesia administration. Monthly audits occur by the perioperative nursing team with known positive outcomes reported accordingly. A positive outcome identified for the preoperative severe risk patient for development of PONV is the preprocedure placement of a Scopolamine 1.5 mg. dermal patch. During an 18 month period, all high risk patients interviewed postprocedure denied incidence of PONV.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.
Conference Date:
2009
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
New Orleans, Louisiana, USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleThe Development of an Evidence-Based Postoperative Nausea and Vomiting Protocol in the Perioperative Settingen_GB
dc.contributor.authorClark, Deborahen_GB
dc.contributor.authorMarvin, Maryen_GB
dc.author.detailsDeborah Clark, OSF Saint Francis Medical Center, Peoria, Illinois, USA, email: debkc@msn.com; Mary Marvinen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157086-
dc.description.abstractPURPOSE: Thirty percent of preoperative patients in general and up to 70% of patients at high risk suffer from postoperative nausea and vomiting (PONV). PONV can increase the patient's risk for aspiration, extended stay, increase financial burden to the patient and institution, increase the patient's discomfort, and decrease patient satisfaction. An evidence based protocol was developed to proactively promote a decrease or elimination of PONV in the perioperative setting. Description: A collaborative perioperative team was formed. After reviewing extensive literature of the patient at risk for developing PONV (including surgical procedures, treatment modalities, and patient demographics) a risk scoring tool was developed. Points were assigned preoperatively for 8 identified risk factors such as patient gender, smoking history, type of surgical procedure, anesthesia type, procedure duration, use of post-op opioids, previous history of motion sickness or prior incidence of PONV. For each risk factor level identified, prophylactic strategies were defined, both pharmacological and nonpharmacological, that could be implemented to benefit the patient for a positive outcome. A physician order set was created to include the risk factor level, intravenous hydration, and medications categorized by drug class for utilization during the perioperative time frame. Prior to initiation, the protocol was approved by multiple hospital committees. Once approval was achieved, a copy of the order set, and risk and prophylaxis table were placed on every patient's chart for utilization by the anesthesia provider and the rest of the perioperative team. EVALUATION: Through utilization of the evidence based protocol for PONV, patients were identified at risk for developing PONV and were treated prior to anesthesia administration. Monthly audits occur by the perioperative nursing team with known positive outcomes reported accordingly. A positive outcome identified for the preoperative severe risk patient for development of PONV is the preprocedure placement of a Scopolamine 1.5 mg. dermal patch. During an 18 month period, all high risk patients interviewed postprocedure denied incidence of PONV.en_GB
dc.date.available2011-10-26T19:24:32Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:24:32Z-
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.conference.date2009en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationNew Orleans, Louisiana, USAen_GB
dc.identifier.citation2009 National Teaching Institute Research Abstracts. American Journal of Critical Care, 18(3), e1-e17.en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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