OSM560-April_DIGITAL_rev_Layout 1 4/8/13 11:09 AM Page 143
ANESTHESIA ALERT
Julie Gilston, RN, and Denise Martel, RN, BSN, CAPA
How to Decrease Your PONV Rates
These 3 steps resulted in a 5% drop in our already-low incidence.
A
t 18%, our rate of
post-operative nau-
sea and vomiting (PONV)
KNOW THE RISK A
female non-smoker likely
to receive narcotics for
pain control after surgery
has a 60% chance of
experiencing PONV.
was already well below
the national average of
Jason Meehan
30%, but we wanted to
lower it even more. Read
on to find out how we
identified high-risk patients, communicated this risk to the anesthesia
team and implemented best practices based on the literature.
1
Use a scoring system to screen patients
Although the anesthesia provider determines what medications the
patient will receive, pre-op nurses should play an important role in
your PONV screening efforts. We educated our nurses on the pathophysiology of PONV, its treatment using a multi-modal approach and
the results of our quality improvement assessment — but realized a
key deficiency in our system. We didn't have a scoring system for
screening patients.
After reviewing the literature, we chose the one developed by Apfel
et al. in 1998. The Apfel system is a simplified PONV predictive scorA P R I L 2 013 | O U T PAT I E N T S U R G E R Y M A G A Z I N E | 1 4 3
