Tabrizi Samira, Malhotra Vinod, Turnbull Zachary A, Goode Victoria
J Perianesth Nurs. 2019 Aug;34(4):851-860. doi: 10.1016/j.jopan.2018.10.006. Epub 2019 Feb 1.
Postoperative nausea and vomiting (PONV) is one of the most common complications after anesthesia. This evidence-based quality improvement (QI) project describes the implementation of a PONV guideline and the impact on providers' compliance with PONV risk assessment using the Apfel PONV score.
A retrospective preimplementation and postimplementation QI project.
This evidence-based QI project sample included 294 adult female patients scheduled for gynecologic or breast surgery in the ambulatory setting. They were observed for PONV in the postanesthesia care unit. In addition, compliance of Apfel risk-assessment score documentation on the preanesthesia evaluation form was assessed.
Postimplementation of the guideline, the overall incidence of PONV was significantly lower (9.5% vs 21.1%, P = .009) and anesthesia providers' adherence to Apfel risk score documentation significantly increased (63.3% vs 49%, P = .019).
A PONV guideline for gynecologic and breast surgery can reduce the PONV incidence and improve anesthesia providers' compliance with PONV risk assessment and its documentation.
术后恶心呕吐（PONV）是麻醉后最常见的并发症之一。这项基于证据的质量改进（QI）项目描述了PONV指南的实施情况以及对医护人员使用阿佩尔PONV评分进行PONV风险评估的依从性的影响。
一项实施前和实施后的回顾性QI项目。
这个基于证据的QI项目样本包括294名计划在门诊进行妇科或乳腺手术的成年女性患者。在麻醉后护理单元观察她们是否发生PONV。此外，还评估了麻醉前评估表上阿佩尔风险评估评分记录的依从性。
指南实施后，PONV的总体发生率显著降低（9.5%对21.1%，P = 0.009），麻醉医护人员对阿佩尔风险评分记录的依从性显著提高（63.3%对49%，P = 0.019）。
针对妇科和乳腺手术的PONV指南可以降低PONV发生率，并提高麻醉医护人员对PONV风险评估及其记录的依从性。
