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PONV / PDNV Clinical Guideline

Postoperative and postdischarge nausea and vomiting (PONV/PDNV) is one of the most commonly occurring postoperative complications; yet, healthcare providers have yet to reach consensus regarding a treatment approach. ASPAN organized a panel consisting of 18 multi-disciplinary, multi-specialty experts to review and analyze the evidence related to the prevention and/or management of PONV/PDNV. Consensus based decision making techniques were used to establish multi-disciplinary, multi-modal evidence-based recommendations regarding risk factor identification and stratification, traditional, and complimentary treatment modalities. Areas of needed research were also identified and prioritized. Translation of these guidelines into practice should improve health outcomes in adult surgical patients.

The American Society of PeriAnesthesia Nurses’ (ASPAN) Evidence-Based Clinical Practice Guideline for the Prevention and/or Treatment of Postoperative Nausea and Vomiting and Postdischarge Nausea and Vomiting in Adult Patients

Problem: Postoperative and post-discharge nausea and vomiting (PONV/PDNV) is one of the most commonly occurring postoperative complications, frequently resulting in prolonged postoperative stay, unanticipated admission and increased health care costs. Yet, health care providers have yet to reach consensus regarding an evidence-based multi-disciplinary, multi-model treatment approach to PONV/PDNV.

Purpose: To develop a multi-modal, multi-disciplinary evidence-based resource for anesthesia providers and nurses involved in the care of patients in inpatient and outpatient settings who are having procedures performed in the operating room, as well as in other locations where sedation or anesthesia may be administered, who are at risk for, or experiencing PONV and/or PDNV

Method: ASPAN organized a Strategic Work Team (SWT) consisting of 18 multi-disciplinary, multi-specialty experts charged with the review and analysis of published evidence related to the prevention and/or management of PONV/PDNV. The evidence was summarized and presented at a consensus conference in March, 2006, with small group discussions among participants to critique and stratify all available evidence. Consensus based decision making techniques were then used to establish multi-disciplinary, multi-modal evidence-based recommendations regarding risk factor identification and stratification, traditional (pharmacological, hydrations, NPO status, etc) and complimentary (acustimulation, aromatherapy, etc) treatment modalities.

Results: One hundred percent consensus was reached on all guideline recommendations. Multi-disciplinary, multi-modal evidence-based recommendations were made regarding risk factor identification and stratification, traditional, and complimentary prophylaxis and management of PONV/PDNV. Areas of needed research in the prevention and management of PONV/PDNV were also identified and prioritized.

Implications for Practice: Translation of this multi-disciplinary, multi-modal evidence-based practice guideline into practice to direct the prevention and/or management of PONV/ PDNV should improve health outcomes in adult surgical patients. 
                                                                                                                                                                                                                

Click here to read the ASPAN PONV/PDNV Clinical Guideline. (pdf) 

For bulk reprints, please contact Commercial Reprints Department, Elsevier, 360 Park Avenue South, New York, NY 10010-1710. Telephone (212)633-3813; fax (212)633-3820; email: reprints@elsevier.com.

 
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