Postoperative Nausea and Vomiting Clinical Trial
Official title:
A Prospective Randomized Evaluation of an Intraoperative Electronic Reminder Module to Enhance Postoperative Nausea and Vomiting Prophylaxis Guideline Adherence
This project intends to develop and implement an electronic reminder for post-operative
nausea and vomiting (PONV) prophylaxis into the Anesthesia Record Keeping System.
Each patient will have his or her PONV risk classified based on the following risk factors:
Female gender, History of PONV, History of Motion Sickness, Non-smoker and Duration of
procedure > 60 minutes.
Patients will be randomized to either receive the PONV reminder or not. Those receiving the
PONV reminder will have the PONV risk assessment and current guideline information for PONV
prophylaxis displayed on the Anesthesia Record Keeping System (ARKS) screen at the beginning
of the case.
At the end of the procedure (specific at documentation of emergence), the reminder will
assess the current status of PONV prophylaxis as per anti-emetic medications administered and
compare the current status to the recommended status based on published guidelines.
If the current status is compatible or exceeds the recommended status the reminder will
silently document compliance.
If published guidelines suggest additional PONV prophylaxis based on the patients risk
profile and a comparison with the currently documented status, an electronic reminder will
appear on the ARKS screen to alert the anesthesia provider of an opportunity to enhance
guideline adherence.
The reminder will not recommend a specific medication, intervention or therapy.
It will be completely the decision of the anesthesia provider if and how to modify the PONV
prophylaxis for the patient.
Subjects randomized to not receive the electronic display will have it deactivated.
Each patient will have his or her PONV risk classified based on the following risk factors
Female gender, History of PONV or Motion Sickness, Non-smoker and Duration of procedure > 60
min utilizing information already entered into the Anesthesia Record Keeping System. Patients
having 0-1 risks factors present will be low risk. 2 risks factors present are medium risk
and more than 2 risk factors present are high risk.
Patients will be randomized to either receive the PONV reminder or not. Those receiving the
PONV reminder will have the PONV risk assessment and current guideline information for PONV
prophylaxis will be displayed on the ARKS screen at the beginning of the case.
In a second step at the end of the procedure (specific at documentation of emergence), the
reminder will assess the current status of PONV prophylaxis as per anti-emetic medications
administered and compare the current status to the recommended status based on published
guidelines.
If the current status is compatible or exceeds the recommended status the reminder will
silently document compliance.
If published guidelines suggest additional PONV prophylaxis based on the patients risk
profile and a comparison with the currently documented status, an electronic reminder will
appear on the ARKS screen to alert the anesthesia provider of an opportunity to enhance
guideline adherence.
The reminder will display the PONV risk assessment information, current status of PONV
prophylaxis as well as the information that current guidelines recommend additional PONV
prophylaxis.
The reminder will not recommend a specific medication, intervention or therapy.
It will be completely the decision of the anesthesia provider if and how to modify the PONV
prophylaxis for the patient.
Subjects randomized to not receive the electronic display will have it deactivated.
;
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