Development and Implementation of Clinical Nursing Practice Guidelines for Prevention and Management of Postoperative Nausea and Vomiting
Keywords:
Clinical nursing practice guidelines, Postoperative nausea and vomiting, Prevention and managementAbstract
Postoperative nausea and vomiting (PONV) is a common complication that occurs during the 24-48 hours after surgery and affects many aspects including healthcare costs. This research aimed to develop clinical nursing practice guidelines (CNPGs) for prevention and management of PONV and to assess the outcomes of implementing the CNPGs in a Southern hospital. The framework of this study is based on the Australian National Health and Medical Research Council (NHMRC). Participants consisted of two groups:1) patients undergoing elective surgery who were staying in the female surgical ward before and during implementation of the CNPGs (80 patients per group), and 2) 24 nurses who utilized the CNPGs. Data collection instruments consisted of 1) the CNPGs Implementation Opinion Survey Form, and 2) the Outcome Evaluation Form. Data were analyzed using descriptive statistics.
The results showed that the CNPGs for prevention and management of PONV consist of three important sections: 1) PONV prevention in the preoperative period, 2) PONV prevention and management in the intraoperative period while receiving anesthesia, and 3) PONV prevention and management in the first 48 hours of the postoperative period. Most of the recommendations in the CNPGs are based on strong evidence (level 1). The feasibility of the CNPG implementation was at a high level (79.17–100%). Postoperative nausea and vomiting were found in participants of the CNPG implementation group (6.25%) at a lower rate than in those from the pre-CNPG implementation group (30.00%). The severity of postoperative nausea in the CNPG implementation group was at a moderate level (100%), which was less than the moderate and severe levels in the pre-CNPG implementation group (81.82% and 18.18%, respectively). Participants in the CNPG implementation group were ‘very satisfied’ and ‘most satisfied’ with care (66.25% and 27.50%, respectively), compared with the pre-CNPG implementation group who reported ‘moderate’ and ‘very satisfied’ levels (17.15% and 68.75%, respectively).
The results of this study revealed that the CNPGs for prevention and management of PONV could be continuously applied to surgical patients to further improve the quality of patient care.
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