Outpatient Surgery Magazine

Marking Madness - April 2013 - Subscribe

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

Issue link: http://outpatientsurgery.uberflip.com/i/122240

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Page 142 of 157

OSM560-April_DIGITAL_Layout 1 4/5/13 2:33 PM 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

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