Date of Award

Spring 2021

Abstract

Postoperative nausea and vomiting (PONV) remains a common complication affecting surgical patients after receiving anesthesia. Prevention of PONV is important in an ambulatory surgical setting where patient access to rescue treatment is limited after discharge. A quality improvement (QI) project introduced a simplified PONV prevention strategy to decrease the incidence of PONV at a Veterans Health Administration ambulatory surgery center. A retrospective chart audit of all facility surgical patients receiving anesthesia care (n = 94), excluding ophthalmology patients, was conducted prior to COVID-19 restrictions to establish baseline PONV incidence. An evidence-based, simplified PONV prevention protocol was developed and implemented. After a 2-week protocol familiarization period an 8-week chart audit of all surgical patients receiving anesthesia care (n = 81) was performed determining post-protocol PONV incidence. The incidence of PONV post-protocol implementation was significantly lower (8.6% vs 19.1%, p < .001). The type of anesthesia administered, monitored anesthesia versus general anesthesia (p = .827), did not influence the incidence of PONV. An unanticipated finding was a significant increase in PACU length of stay between post-protocol and baseline samples (86 minutes vs 71.5 minutes, p = .001). Implementation of a simplified protocol for the prevention of PONV resulted in a significant reduction in PONV incidence.

Document Type

Clinical Doctorate

First Advisor

Sue Fetzer

Second Advisor

John McNemar

College or School

CHHS

Department or Program

Nursing

Degree Name

Other

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