Decision support increases guideline adherence for prescribing postoperative nausea and vomiting prophylaxis

Area of Science:

• Anesthesiology
• Patient Safety
• Health Informatics

Background:

• Postoperative nausea and vomiting (PONV) prevention guidelines are widely used but adherence is often poor.
• Electronic decision support (DS) systems may improve adherence to clinical guidelines.
• This study investigated the impact of a DS system on PONV prophylaxis adherence.

Purpose of the Study:

• To evaluate the effectiveness of an electronic decision support (DS) system in improving adherence to postoperative nausea and vomiting (PONV) prevention guidelines.
• To assess the impact of DS on the correct prescription of PONV prophylaxis in high-risk patients.

Main Methods:

• Anesthesia information management system used for data entry at preoperative screening.
• PONV prevention guidelines identified high-risk patients based on specific risk factors.
• An off-on-off study design with automated reminders evaluated DS impact on guideline adherence.

Main Results:

• The percentage of high-risk patients identified increased with mandatory data entry.
• Adherence to PONV prophylaxis prescription increased from 38% in the control period to 73% during the DS period.
• Adherence decreased to 37% in the post-DS period, indicating a significant effect of the DS system.

Conclusions:

• Electronic decision support systems significantly improve adherence to PONV prophylaxis guidelines.
• DS systems are effective in increasing the correct prescription of prophylaxis for high-risk PONV patients.