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A Quality Improvement Project to Prevent Postoperative Nausea and Vomiting
Abstract
Problem & Purpose: Postoperative nausea and vomiting are associated with patient dissatisfaction, prolonged hospital stays, unanticipated hospital admissions, and increased cost of care. Approximately 40% of patients undergoing laparoscopic procedures at a community hospital experienced postoperative nausea and vomiting. The purpose of this quality improvement project was to implement and evaluate compliance with the evidence-based Apfel risk screening and prophylaxis treatment tool. Methods: A multidisciplinary team, including a Clinical Site Representative, Certified Registered Nurse Anesthetist, Sponsor, Chief Certified Registered Nurse Anesthetist, and the nurse managers of the pre-operative and Post Anesthesia Care Unit were mobilized to implement a new protocol. Educational materials were disseminated to all providers through in-person meetings and protocol copies. Following the training, providers utilized the Apfel screening tool, treated the eligible patients with the recommended antiemetics, and documented the postoperative nausea and vomiting risk score. Eligible patients included 227 adults undergoing laparoscopic surgeries. Results: Of the 227 eligible patients, a total of 68 patients (30%) were appropriately screened and treated. Of the 68 patients screened and treated, a total of 47 patients (70%) did not require antiemetics during the postoperative period. The median provider compliance with the protocol was 30%. The median percentage of laparoscopic patients not requiring antiemetics during the postoperative period improved from 40% (baseline) to 70%. Conclusion: Findings suggest that implementing a postoperative nausea and vomiting protocol was a feasible and sustainable intervention at this site. Compliance and treatment with the protocol reduced the incidence of postoperative nausea and vomiting.Identifier to cite or link to this item
http://hdl.handle.net/10713/22824Collections
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