Who is at risk for postdischarge nausea and vomiting after ambulatory surgery?

Background: About one in four patients suffers from postoperative nausea and vomiting. Fortunately, risk scores have been developed to better manage this outcome in hospitalized patients, but there is currently no risk score for postdischarge nausea and vomiting (PDNV) in ambulatory surgical patients.

Methods: We conducted a prospective multicenter study of 2,170 adults undergoing general anesthesia at ambulatory surgery centers in the United States from 2007 to 2008.

Evidence-based case management practice-part II: meta-analysis: a primer for case managers.

Objectives: This article aims to (1) describe the steps in the development of a meta-analysis, (2) discuss the use of meta-analysis in developing an evidence base for case management practice, and (3) provide some basic guidelines for evaluating the meta-analysis.

Primary Practice Settings: Evidence-based practice (EBP) is a mandate for all healthcare professionals, regardless of setting. Although many institutions lack library resources, systematic reviews and meta-analyses are available from multiple sites on the Internet.

Evidenced-based case management practice, part 1: the systematic review.

Objectives: This article aims to (1) describe the steps in the development of a systematic review, (2) discuss the use of systematic reviews in developing an evidence base for case management practice, and (3) present listings of agencies that provide systematic reviews on clinical topics and resources to evaluate systematic reviews for application to practice.

Primary Practice Settings: Evidence-based practice is mandated for all healthcare professionals regardless of setting. For nonacademic settings, a lack of library resources may make this mandate difficult to accomplish.

Perianesthesia nursing advocacy: an influential voice for patient safety.

Perianesthesia nurses are called to advocate for their patients, promote a safe work environment, and contribute to the continued advancement of the nursing profession. Nurses must demonstrate vigilance in their nursing care to protect patients from harm. It is an ethical and legal responsibility to request physicians to review with patients their informed consents when they report they do not understand or have questions about the surgical procedure.

Medication errors in the PACU.

A collaborative research group examined seven years of PACU medication errors from the MEDMARX database. Descriptive statistics showed a comparison of medication errors in all ages from pediatric to adult to geriatric groups. Nine categories of medication errors were noted and a total of 3,023 errors were attributed to errors in prescribing, transcribing, dispensing, administering, and monitoring.

Safe staffing for the post anesthesia care unit: weighing the evidence and identifying the gaps.

Postanesthesia nursing care and standards are continually evolving. ASPAN has the professional responsibility to develop standards of nursing practice to promote a safe environment of care. Currently, ASPAN's recommended staffing ratios are based on the best available evidence: expert opinion and consensus.

Patient safety: perianesthesia nursing's essential role in safe practice.

A safety culture that promotes best practices and best outcomes is important in today's healthcare environment. The perianesthesia environment of care is constantly challenged with the introduction of new technologies, improved medications, and advances in surgical and nonsurgical procedures. This practice is also marked by fast turnover, increasing volume, and, often, high-acuity patients.

Development and initial testing of the perianesthesia safe practices instrument: an ASPAN pilot study.

The perianesthesia environment of care is a unique high-risk health care setting that has a high susceptibility to error because of the vulnerability of patients who are undergoing surgery and anesthesia as well as the high levels of activity in these units. Safe practice in this environment is essential to quality patient care and positive patient outcomes. Consequently, ASPAN conducted a descriptive cross-sectional pilot study to test initial reliability and validity of the Perianesthesia Safe Practices Survey Instrument.

Outcomes research: a paradigm shift for nursing research.

A short synopsis describing three approaches to outcomes measurement and ten simple steps to improve outcomes. Outcomes research is important for nursing researchers to consider in helping identify strategies to improve the quality and delivery of patient care.

Prevention and management of postoperative nausea and vomiting: a look at complementary techniques.

Complementary modalities, used alone or in combination with pharmacologic therapies, play an important role in the prevention and management of postoperative nausea and vomiting (PONV) and post discharge nausea and vomiting (PDNV). This article will review the evidence for the effective use of complementary modalities: acupuncture and related techniques, aromatherapy, and music therapy that may be integrated in the perianesthesia nurse's plan of care to prevent or manage PONV.