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6 • S U P P L E M E N T T O O U T PAT I E N T S U R G E R Y M A G A Z I N E • J U N E 2 0 1 8 comfort patients both physically and emotionally. TIEO therapy has proven effective in addressing these needs. TIEO therapy is defined as the "skilled and controlled use of pure, therapeutic level inhaled essential oil vapor for physical and emotional health and well-being", which is specifically designated as an independent nursing intervention that does not require a physician's order. When used for managing nausea, it involves the inhalation of carefully-selected essential oil vapors that transit directly to the limbic system, where it suspends the nausea feedback loop, decreasing the feeling of nausea. In recent years, essential oil use in the US has grown significantly. So has the body of research that confirms particular essential oils have the ability to reduce and/or eliminate nausea. Ranging from investigational reviews to IRB-approved research, 14 studies on the TIEO product QueaseEASE have shown statistically significant outcomes, including relief from nausea in PACU and post- discharge, increased patient satisfaction, decreased need for antiemetic drugs, and decreased time spent in PACU. It is important to note that the double-blinded, randomly- controlled research model—a gold standard of medical research—is difficult to apply to scented products such as essential oils. This limitation had caused staunchly conservative medical practitioners to view the evidence as weak or unconvincing. While there remains uncertainty about how TIEO works at a cellular level, established research institutions like Saint Jude's Children's Hospital and the Mayo Clinic have incorporated TIEO products such as QueaseEASE into their patient care services. ADVANTAGES OF TIEO FOR PONV With the increased emphasis on using evidence-based protocols to ensure enhanced patient recovery at minimal cost, nurses are looking to employ innovative methods that can be administered easily and accessed quickly, to help comfort patients physically and emotionally. TIEO therapy has proven effective in addressing these needs. TIEO products can be stocked as regular supply items, resulting in easier procurement. This allows nursing staff to manage their patients' nausea more quickly, which is significant as early nausea intervention has been shown to decrease progression to vomiting. And because TIEO therapy does not interfere with medications or have unwanted side effects, it is safe for patients with complex medical histories, cognitive impairment, or advanced age (when dispensed in hospital-appropriate delivery systems). Essential oils also contain anti-inflammatory, antispasmodic and anxiolytic functions, which further assist in relieving pain and discomfort. CONSIDERING TIEO FOR YOUR FACILITY There are three current trends in US healthcare policy that will critically influence healthcare delivery and reimbursement in the coming decade: Value-based care, which looks at both quality and quality in relation to cost, Enhanced Recovery After Surgery (ERAS) through evidence-based strategies, and updates in the Joint Commission's safety guidelines and accreditation procedures—three areas that TIEO therapy may be able to benefit medical facilities. Pivoting to Value-Based Care A renewed dedication to healthcare quality emerged from the 2010 Patient Protection and Accountable Care Act. Its primary objective is to improve quality while lowering healthcare costs and expanding access. Termed 'value- based care', the approach is comprised of multiple initiatives that transition traditional fee-for-service payment models to a system that focuses on better outcomes, better care and lower costs for patients. Value- based models reward providers for investing in innovative ways to deliver safety and improved patient experience. TIEO therapy compliments the value-based care model in several ways: * Minimized risk: As a non-drug treatment option, TIEOs reduce the risk of side effects and drug interactions that lead to prolonged hospital stay or readmission. * Improved care experiences: TIEO therapy can provide patients with an added sense of autonomy over their care, by allowing them to control the timing and delivery of their medications. * Lower cost treatment option for patients: Some TIEO products are designed to be used multiple times and last from several days to several months, often covering