Assessing Aromatherapy Compliance in the Post-Anesthesia Care Unit

Abstract

Problem & Purpose: Aromatherapy is effective in post-operative nausea and vomiting (PONV) management in post-anesthesia care units (PACU). Aromatic inhalers were previously implemented in the PACU at a tertiary care hospital in Maryland before the COVID-19 pandemic. This evidence-based practice was discontinued during the pandemic, and the supply of aromatic inhalers was not maintained. The purpose of this quality improvement (QI) project was to reinstate the hospital’s practice of aromatherapy utilizing bulk peppermint essential oil for colorectal surgical patients in the PACU. Methods: Approval was obtained from the infection prevention, pharmacy, and PACU directors before implementation. An evidence-based aromatherapy administration protocol was introduced for colorectal patients in the PACU, and the nursing staff received an in-service on implementation procedures. After administering aromatherapy, nurses documented the intervention in patients’ electronic health records. Chart reviews were conducted weekly to audit nursing compliance. This project was expected to impact approximately 50 colorectal patients over the 15-week implementation. Results: Aromatherapy supplies were available in the designated location throughout the implementation period. One hundred percent of PACU nurses received education about the new protocol. The rate of aromatherapy administration compliance was 38%. The rate of PONV during implementation was 17%. Conclusions: Findings suggest a low compliance rate with aromatherapy administration. Implementation of the protocol has not reduced the PONV rate among colorectal patients in the PACU. Low compliance may be related to documentation burden or increased level of sedation among this patient population. Aromatherapy compliance may improve if offered upon PACU discharge when patients are more alert and participatory in care.