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Pediatric Postoperative Nausea and Vomiting: Assessing the Impact of Evidence-Based Practice Change

Robert W Simon1

  • 1is a staff nurse anesthetist for the Holy Redeemer Health System in Pennsylvania and serves as Didactic Education Coordinator and faculty member for the Frank J. Tornetta School of Anesthesia at Einstein Medical Center Montgomery, Norristown, Pennsylvania.

AANA Journal
|July 29, 2020
PubMed

Insights

Documenting a child's history of postoperative nausea and vomiting (PONV) before surgery significantly reduces its occurrence. This practice change lowered PONV rates by 22% in pediatric patients.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Evidence-Based Practice

Background:

  • Postoperative nausea and vomiting (PONV) is a common complication after anesthesia and surgery.
  • Children are twice as likely as adults to experience PONV.
  • Key risk factors include age over 3 years, surgery duration over 30 minutes, surgical type, and prior PONV history.

Purpose of the Study:

  • To evaluate if preoperative documentation of pediatric patients' PONV history reduces postoperative PONV rates.
  • To implement and assess an evidence-based practice change aimed at improving PONV management in children.

Main Methods:

  • A PONV history assessment tool was introduced.
  • A retrospective chart review compared PONV rates in 2,279 cases before the intervention with 2,006 cases after.
  • Data analysis focused on the impact of documented PONV history on postoperative outcomes.

Main Results:

  • A significant decrease in PONV rates was observed post-intervention (153 vs. 120 cases).
  • The overall incidence of PONV dropped by 22%.
  • This reduction was statistically significant (P = .0043) and linked to documented PONV history.

Conclusions:

  • Preoperative documentation of a patient's PONV history is effective in lowering postoperative PONV rates in pediatric populations.
  • Implementing targeted assessments for PONV history represents a successful evidence-based practice change.
  • This strategy contributes to improved patient safety and comfort following surgical procedures.

Keywords:
Pediatricpostoperative nausea and vomitingrisk assessment

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