title: [Postoperative nausea and vomiting: cost and advantage induced by a quality insurance programme. Part I: post anaesthesia care unit].
abstract: OBJECTIVE
  To report the efficiency and direct cost induced by a quality insurance programme (QIP) aimed to reduce the incidence of post-operative nausea and vomiting (PONV) in the post-anaesthesia care unit.
  
  
  METHODS
  Prospective and descriptive study.
  
  
  METHODS
  The occurrence and treatment of PONV were prospectively recorded in the post-anaesthesia care unit in a standardised file before and following therapeutic recommendations made by volunteers component of a QIP. Prophylaxis was administered to patients according to a score of risks based on the type of surgery and patient characteristics. The real cost induced by this change of practice was evaluated according to pharmacists' accounts over 1 year.
  
  
  RESULTS
  The QIP was associated to a 33.5% reduction of PONV relative risk and a 50% increase in prophylactic treatments. When this reduction of PONV was extrapolated to the total number of anaesthesia over 1 year, this QIP avoided PONV in 770 patients each year. The increase of cost reached 3572 as the cost by patient receiving a prophylactic treatment increased from 0.66 to 1.
  
  
  CONCLUSIONS
  Despite an increase in the individual cost of PONV prophylaxis, the selection of patients by a "home" score of risk limits the indications of prophylactic treatment. Thus the increase in cost remains in acceptable ranges.
authors.affiliation: Département d'anesthésie-réanimation, CHU Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges, France. isabelle.odin@unilim.fr
authors.forename: I
authors.initials: I
authors.lastname: Odin
authors.forename: J C
authors.initials: JC
authors.lastname: Merle
authors.forename: P
authors.initials: P
authors.lastname: Feiss
authors.forename: N
authors.initials: N
authors.lastname: Nathan
mesh_terms: D000328:Adult; D000762:Anesthesia Recovery Period; D000932:Antiemetics / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010607:Pharmacy Service, Hospital / Q000191:economics; D020250:Postoperative Nausea and Vomiting / Q000191:economics* / Q000517:prevention & control; D011446:Prospective Studies; D011785:Quality Assurance, Health Care
chemical_list: D000932:Antiemetics