In This Section      

Johns Hopkins Medicine Suburban - Nursing Initiative Tackles Post-Op Nausea

New Directions Summer 2013

Nursing Initiative Tackles Post-Op Nausea

Date: July 1, 2013

Kelly Rosenberg with patient before surgery
Kelly Rosenberg, BSN, RN, left, interviews a patient before surgery to determine her likelihood of experiencing postoperative nausea and vomiting.

Many patients recovering from surgery are challenged by postoperative nausea and vomiting. In fact, it is the most common postoperative complication, affecting one-third of all surgical patients each year. In an effort to minimize the likelihood of this discomfort, Suburban Hospital formed a collaborative work group a year ago comprising nursing, pharmacy and anesthesiology staff.

The Suburban group project began a research study to determine if following the American Society of PeriAnesthesia Nursing Guidelines for the Management of Postoperative Nausea/Vomiting would reduce its prevalence in the hospital’s post-anesthesia care unit (PACU.) Per these guidelines, patients are screened before surgery for risk factors to determine their likelihood of experiencing postoperative nausea or vomiting. Women, nonsmokers and patients receiving anesthetic gases and/or opiates have a higher risk of postoperative nausea. Additional risk factors include patients with a history of motion sickness and/or a history of previous nausea or vomiting after surgery. The more risk factors a patient presents with, the higher the “score.”

After the screening, the information is shared with the anesthesiologist, who then administers the appropriate treatment based on the patient’s risk assessment score. Treatments can include administration of anti-emetics (anti-nausea drugs) and use of regional blocks.

“Taking these research findings and implementing a practice change is having a significant impact on decreasing this uncomfortable problem for our surgical patients,” says Clinical Nurse Educator Karin Nevius, BSN, RN, CPAN, CAPA, CCRN.