Standardised electronic algorithms for monitoring prophylaxis of postoperative nausea and vomiting

Introduction Despite comprehensive guidelines with high-grade evidence, postoperative nausea and vomiting (PONV) remains a frequent problem in anaesthesia care. Anaesthesia information management systems (AIMS) may aid clinicians in PONV prevention, but their benefit is critically dependent on the d...

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Autores principales:	Hans-Jörg Gillmann, Sascha Wasilenko, Jonathan Züger, Antje Petersen, Anna Klemann, Andreas Leffler, Thomas Stueber
Formato:	article
Lenguaje:	EN
Publicado:	Termedia Publishing House 2019
Materias:	ponv patient safety anesthesiology perioperative management documentation aims postoperative nausea and vomiting anaesthesiology anaesthesia information management systems Medicine R
Acceso en línea:	https://doaj.org/article/6960894af6224d5ca4823cf62329cddf
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spelling	oai:doaj.org-article:6960894af6224d5ca4823cf62329cddf2021-12-02T16:59:26ZStandardised electronic algorithms for monitoring prophylaxis of postoperative nausea and vomiting1734-19221896-915110.5114/aoms.2019.83293https://doaj.org/article/6960894af6224d5ca4823cf62329cddf2019-03-01T00:00:00Zhttps://www.archivesofmedicalscience.com/Standardised-electronic-algorithms-for-monitoring-prophylaxis-of-postoperative-nausea,69857,0,2.htmlhttps://doaj.org/toc/1734-1922https://doaj.org/toc/1896-9151Introduction Despite comprehensive guidelines with high-grade evidence, postoperative nausea and vomiting (PONV) remains a frequent problem in anaesthesia care. Anaesthesia information management systems (AIMS) may aid clinicians in PONV prevention, but their benefit is critically dependent on the details of implementation into practice. This study aimed to examine strengths and weaknesses of the local AIMS-based algorithm in prevention of PONV. Material and methods This retrospective study was conducted in the post-anaesthesia care unit (PACU) of a university hospital and included 10 604 patients aged 18 or older who were followed up in the PACU (intracranial, obstetrical or cardiothoracic surgery excluded) from March 2013 until March 2014. The PONV incidence in PACU and AIMS data validity were analysed. Results Adherence to PONV guideline recommendations was considerably low, with only 5749 (54%) of the patients receiving correct PONV prophylaxis. Two thousand seven hundred sixty-six (26%) of the patients received an insufficient PONV prophylaxis, which was associated with an excess PONV incidence (11% vs. 4% with correct prophylaxis, p < 0.001) in the PACU. Two thousand four hundred forty-nine (23%) of all patients were discharged from the PACU with an insufficient PONV prophylaxis despite perioperative digital PONV prevention algorithms. Conclusions Adherence to PONV prophylaxis guidelines in the era of AIMS software and decision support is still remarkably low. The AIMS data usefulness depends on the user, the type of data input and the configuration of the software. Adherence to correct PONV prophylaxis should be re-evaluated systematically before discharge from PACU.Hans-Jörg GillmannSascha WasilenkoJonathan ZügerAntje PetersenAnna KlemannAndreas LefflerThomas StueberTermedia Publishing Housearticleponvpatient safetyanesthesiologyperioperative managementdocumentationaimspostoperative nausea and vomitinganaesthesiologyanaesthesia information management systemsMedicineRENArchives of Medical Science, Vol 15, Iss 2, Pp 408-415 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	ponv patient safety anesthesiology perioperative management documentation aims postoperative nausea and vomiting anaesthesiology anaesthesia information management systems Medicine R
spellingShingle	ponv patient safety anesthesiology perioperative management documentation aims postoperative nausea and vomiting anaesthesiology anaesthesia information management systems Medicine R Hans-Jörg Gillmann Sascha Wasilenko Jonathan Züger Antje Petersen Anna Klemann Andreas Leffler Thomas Stueber Standardised electronic algorithms for monitoring prophylaxis of postoperative nausea and vomiting
description	Introduction Despite comprehensive guidelines with high-grade evidence, postoperative nausea and vomiting (PONV) remains a frequent problem in anaesthesia care. Anaesthesia information management systems (AIMS) may aid clinicians in PONV prevention, but their benefit is critically dependent on the details of implementation into practice. This study aimed to examine strengths and weaknesses of the local AIMS-based algorithm in prevention of PONV. Material and methods This retrospective study was conducted in the post-anaesthesia care unit (PACU) of a university hospital and included 10 604 patients aged 18 or older who were followed up in the PACU (intracranial, obstetrical or cardiothoracic surgery excluded) from March 2013 until March 2014. The PONV incidence in PACU and AIMS data validity were analysed. Results Adherence to PONV guideline recommendations was considerably low, with only 5749 (54%) of the patients receiving correct PONV prophylaxis. Two thousand seven hundred sixty-six (26%) of the patients received an insufficient PONV prophylaxis, which was associated with an excess PONV incidence (11% vs. 4% with correct prophylaxis, p < 0.001) in the PACU. Two thousand four hundred forty-nine (23%) of all patients were discharged from the PACU with an insufficient PONV prophylaxis despite perioperative digital PONV prevention algorithms. Conclusions Adherence to PONV prophylaxis guidelines in the era of AIMS software and decision support is still remarkably low. The AIMS data usefulness depends on the user, the type of data input and the configuration of the software. Adherence to correct PONV prophylaxis should be re-evaluated systematically before discharge from PACU.
format	article
author	Hans-Jörg Gillmann Sascha Wasilenko Jonathan Züger Antje Petersen Anna Klemann Andreas Leffler Thomas Stueber
author_facet	Hans-Jörg Gillmann Sascha Wasilenko Jonathan Züger Antje Petersen Anna Klemann Andreas Leffler Thomas Stueber
author_sort	Hans-Jörg Gillmann
title	Standardised electronic algorithms for monitoring prophylaxis of postoperative nausea and vomiting
title_short	Standardised electronic algorithms for monitoring prophylaxis of postoperative nausea and vomiting
title_full	Standardised electronic algorithms for monitoring prophylaxis of postoperative nausea and vomiting
title_fullStr	Standardised electronic algorithms for monitoring prophylaxis of postoperative nausea and vomiting
title_full_unstemmed	Standardised electronic algorithms for monitoring prophylaxis of postoperative nausea and vomiting
title_sort	standardised electronic algorithms for monitoring prophylaxis of postoperative nausea and vomiting
publisher	Termedia Publishing House
publishDate	2019
url	https://doaj.org/article/6960894af6224d5ca4823cf62329cddf
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Standardised electronic algorithms for monitoring prophylaxis of postoperative nausea and vomiting

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