Abstract

Session presented on Friday, July 24, 2015:

Evaluation of the Implementation of the ASPAN's Evidence-Based Clinical Practice Guideline for the Prevention and/or Treatment of Postoperative Nausea and Vomiting Lisa Stephens DNP, CRN Assistant Professor Georgia Regents University Augusta, GAAims: Postoperative nausea and vomiting (PONV) impacts up to 60% of surgical patients annually. Evidence based guidelines have been developed to guide the prevention/management of PONV; however the impact of guideline implementation on patient outcome has not been evaluated. The purpose of this study was to evaluate the relationship of implementation of anesthesia specific guideline recommendations to the incidence of PONV. A cost/benefit analysis was also conducted. Methods: A secondary data analysis was conducted of local data (N=94) obtained during a prospective multi-center trial involving medical record abstraction and patient jouRNing (N = 2170). The purpose of the original study was to develop a simplified risk model for the prediction of PDNV. Results: Data analysis included descriptive statistics and correlation. 38% of patients were treated according to guideline recommendations; 37% were undertreated and 19% over-treated. Overall incidence of PONV was 22.3%. Number of PONV risk factors and number of anti-emetic medications administered were weakly correlated (r = 0.21, p = 0.004). Incidence of PONV was 18.4% for patients treated according to guideline recommendations, and 35.1% in undertreated patients. Incidence of PONV was 5.2 % in patients that were over-treated. Conclusion: Risk assessment through the use of evidence-based guidelines such as the ASPAN Guideline helps identify patients who would benefit from prophylactic antiemetics and assist providers in identifying strategies to greatly reduce or even eliminate its occurrence. Future research determining the efficacy of the ASPAN guideline is necessary to suggest changes, if any, to the guideline and guide future advancements in algorithm development to eliminate PONV.

Authors

Lisa Stephens

Author Details

Lisa Stephens, CRN

Sigma Membership

Non-member

Lead Author Affiliation

Georgia Regents University, Augusta, Georgia, USA

Type

Poster

Format Type

Text-based Document

Study Design/Type

N/A

Research Approach

N/A

Keywords:

Postoperative Nausea and Vomiting, Guideline Implementation

Conference Name

26th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

San Juan, Puerto Rico

Conference Year

2015

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Evaluation of the implementation of ASPAN's evidence-based clinical practice guideline for the prevention and/or treatment of postoperative nausea and vomiting

San Juan, Puerto Rico

Session presented on Friday, July 24, 2015:

Evaluation of the Implementation of the ASPAN's Evidence-Based Clinical Practice Guideline for the Prevention and/or Treatment of Postoperative Nausea and Vomiting Lisa Stephens DNP, CRN Assistant Professor Georgia Regents University Augusta, GAAims: Postoperative nausea and vomiting (PONV) impacts up to 60% of surgical patients annually. Evidence based guidelines have been developed to guide the prevention/management of PONV; however the impact of guideline implementation on patient outcome has not been evaluated. The purpose of this study was to evaluate the relationship of implementation of anesthesia specific guideline recommendations to the incidence of PONV. A cost/benefit analysis was also conducted. Methods: A secondary data analysis was conducted of local data (N=94) obtained during a prospective multi-center trial involving medical record abstraction and patient jouRNing (N = 2170). The purpose of the original study was to develop a simplified risk model for the prediction of PDNV. Results: Data analysis included descriptive statistics and correlation. 38% of patients were treated according to guideline recommendations; 37% were undertreated and 19% over-treated. Overall incidence of PONV was 22.3%. Number of PONV risk factors and number of anti-emetic medications administered were weakly correlated (r = 0.21, p = 0.004). Incidence of PONV was 18.4% for patients treated according to guideline recommendations, and 35.1% in undertreated patients. Incidence of PONV was 5.2 % in patients that were over-treated. Conclusion: Risk assessment through the use of evidence-based guidelines such as the ASPAN Guideline helps identify patients who would benefit from prophylactic antiemetics and assist providers in identifying strategies to greatly reduce or even eliminate its occurrence. Future research determining the efficacy of the ASPAN guideline is necessary to suggest changes, if any, to the guideline and guide future advancements in algorithm development to eliminate PONV.