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Improving Anesthesia Provider Compliance with a Postoperative Nausea and Vomiting Prophylaxis Protocol
Abstract
Problem: At a community hospital, an estimated 33% of ambulatory surgery adult patients experience postoperative nausea and vomiting (PONV). The hospital’s chief nurse anesthetist reports 25% compliance among nurse anesthetists with the existing PONV prophylaxis protocol. Purpose: The purpose of this quality improvement project is to increase the compliance of nurse anesthetists with the PONV prophylaxis protocol for adult patients undergoing elective procedures with general anesthesia. Methods: Implementation strategies for the practice change include the placement of a large poster of the protocol in the anesthesia lounge and in each operating room and conducting a formal information session on the protocol. Additionally, the Project Lead performed weekly audits of the facility’s “PONV Dashboard,” wherein the compliance score of each anesthesia provider is tracked, and informed the nurse anesthetists of their weekly compliance and ongoing performance with the protocol. Results: In the first week, there was an average compliance score of 43% with the protocol. In subsequent weeks, the average compliance increased to 58% then 83%. However, there was a decrease in compliance scores from weeks 4 through 9. Of note, a change in the frequency of the PONV Dashboard being updated caused lags in nurse anesthetists receiving feedback on their compliance. After week 9, the compliance scores were updated from the previous month and compliance began to improve until the next time scores were made available. Conclusions: The findings point to the display of a protocol in highly visible spaces and routinely informing providers of how well they comply with the protocol as methods to increase protocol compliance. By keeping providers engaged with their performance, they are more likely to adhere to a PONV protocol, with the implication of a reduction in the occurrence of PONV for patients following general anesthesia.Identifier to cite or link to this item
http://hdl.handle.net/10713/22744Collections
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