Problem and Purpose: At a community hospital in Baltimore, Maryland, the incidence of postoperative nausea and vomiting (PONV) among the adult laparoscopic surgical patient population, excluding gynecologic patients, is 21%. At the stie, there is no evidence based PONV risk assessment or prevention guideline for anesthesia providers to use to assess patients’ risk and create an individualized prophylaxis plan. The purpose of this quality improvement (QI) project was to implement a PONV risk assessment tool (Apfel Score) and prophylactic treatment guideline for non-gynecologic, laparoscopic surgical patients. The outcome goal was to reduce the rate of PONV in this population from a baseline of 21%. Methods: The anesthesia department consisting of approximately 60 anesthesia providers received education about use of the Apfel Score and treatment guideline prior to implementation. The Apfel Score and guideline were emailed to staff and posted throughout the preoperative area and at anesthesia workstations for provider reference. Patient charts were reviewed weekly to track compliance with Apfel Score completion, adherence to the treatment guideline, and to monitor PONV occurrences. Results: Of the 90 eligible patients, 28% were screened for PONV risk using the Apfel Score. Of the 25 patients with a documented Apfel Score, 84% received the appropriate number of antiemetics per the prophylaxis guideline. The overall rate of PONV decreased 5% from the 21% baseline measurement. Conclusions: Use of an evidence based PONV risk assessment tool such as the Apfel Score and an associated treatment guideline are simple, feasible interventions to implement that address the problem of PONV. When staff comply with both the risk assessment and prophylaxis guideline, PONV occurrences decrease. Although PONV incidence decreased from baseline by the end of implementation, bolstered compliance with the two-part intervention has the potential to contribute to a further decrease in PONV.