Graduation Semester and Year

Summer 2025

Language

English

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Cathy Brown

Second Advisor

Patti Parker

Abstract

This manuscript explores strategies to address postoperative nausea and vomiting (PONV), a significant complication affecting up to 30% of surgical patients and 80% of those at high risk. Despite its prevalence, appropriate prophylactic administration of antiemetic medications remains suboptimal, with national rates at 67% and certain academic facilities reporting only 32%, far below the 90% recommended threshold. These deficiencies underscore the urgent need for evidence-based interventions to enhance clinical adherence and improve patient care outcomes.

A quality improvement (QI) initiative was implemented to enhance prophylactic treatment and reduce inefficiencies in PONV management. Following a comprehensive literature review, the project employed clinician education, a practice advisory tool, and a revised order set grounded in evidence-based practice. Over an eight-week timeline, the QI project demonstrated substantial improvements, with prophylactic antiemetic administration increasing by 37%, inefficient recovery room treatments decreasing by 27%, and the incidence of PONV reduced by 14%. These findings underscore the importance of targeted interventions in mitigating the impact of PONV on patients and healthcare systems. By synthesizing best practices and leveraging clinician education, this manuscript offers constructive insights into efficient PONV management, advocating for the broader adoption of quality improvement (QI) initiatives to address care gaps and optimize perioperative outcomes.

Keywords

PONV, Management, Ondansetron, QI, Anesthesia

Disciplines

Other Nursing | Perioperative, Operating Room and Surgical Nursing

License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Comments

I would like to acknowledge my project team for all of their help and encouragement:

Lida Shaygan, DO., Kunal Karamchandani, MD., Trent Bryson, MD., Mishal Johny, M.s., and Bailor Hardman, MD

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