Problem statement
Antiemetics are routinely administered by anesthesia providers to patients undergoing
general anesthesia based on a variety of causes. Despite this intervention, postoperative nausea
and vomiting occurs in 30% of surgical patients undergoing general anesthesia and up to 70% to
80% of these patients are high-risk. Anesthesia providers at Kosciusko Community Hospital
(KCH) fall under the above mention statistics.
Purpose
This DNP Scholarly project attempted to evaluate the utilization of a risk stratification
algorithm to decrease the incidence of PONV at KCH.
Methods
During the evaluation of the implementation of the risk stratification algorithm for
decreasing the incidence of PONV, a pre/post chart review intervention survey. It tracked the use
of the APFEL score (a risk stratification algorithm) for the prevention of PONV over a fourweek. interval. The interventions endeavored to increase the utilization of the APFEL score by
Inclusion Criteria
Project participants comprised all permanent anesthesia providers and PACU nurses.
Results
Post intervention results showed that anesthesia providers at KCH used the APFEL score
which resulted to a decrease in the incidence of PONV. There was a percentage increase of
100% in the utilization of the APFEL score, a percentage decrease of 60% in PACU length of
stay due to PONV complications and a percentage decrease of 40% in the incidence of PONV.
Implications
It is crucial to avoid PONV than to treat. Even though no single method has been proven
to be effective in treating PONV, a multimodal approach is justified, and it includes the use of a
risk stratification tool.