Perioperative Management of Postoperative Nausea and Vomiting: A Quality Improvement Project

Abstract

Postoperative nausea and vomiting (PONV) is an adverse event affecting 30% of the general surgical population and up to 80% of high risk patients. In addition to being distressing to patients, PONV is also associated with longer stays in PACU and increased hospital admissions and health care costs. The purpose of this scholarly project was to assess the CRNAs’ knowledge, preferences, and practices for managing PONV and whether or not they perceived a PONV quick reference guideline as a useful tool for their practice to aid in identifying high-risk patients, managing baseline PONV risks, and selecting strategies for prophylaxis and rescue treatment. A copy of the Quick Reference Guide, educational PPT, and pre and post intervention surveys were created and shared via email with participants. Results were analyzed and compared to assess the perceptions of the CRNAs regarding usefulness of the Quick Reference Guide. Overall, post-survey responses indicate participants read the information provided and perceived the Quick Reference Guide handout to be useful. Most participants perceived the Quick Reference Guide would be useful if implemented in the department. A major limitation of the project included the number of responses from the pre and post implementation surveys. The financial impact to the institution to implement this guide would be minimal, and decreasing PONV rates would save money long term. For future research, larger sample size of participants is recommended so results can more accurately reflect trends in pre versus post implementation knowledge on the subject.