Documentation of post-operative nausea and vomiting in routine clinical practice.
This study investigated the quality of documentation of post-operative nausea and vomiting (PONV) by comparing incidences collected by a research team with those reported routinely by nursing personnel. A total of 560 patients passing through an interdisciplinary recovery room were included in the study. The overall recorded incidence of PONV over 24 h was 30.7%, which was in agreement with the predicted value of 32% calculated using incidences from published randomized controlled trials. Out of the total number of 86 cases of PONV in the recovery room only 36 (42%) were detected by nursing staff. Similarly, out of the total number of 129 cases of PONV on the ward over 24 h, only 37 (29%) were recognized by nursing staff during routine care. In conclusion, PONV in routine clinical care is likely to be under-reported. To use PONV as a valid quality measure, patients need to be actively asked about nausea and vomiting at frequent intervals in a standardized fashion. A considerable proportion of patients experience PONV after discharge from the recovery room, so the assessment of PONV should cover at least 24 h post-operatively.
Franck
M
M
Department of Anaesthesia and Intensive Care, Charité - Universitaetsmedizin Berlin, Berlin, Germany.
Radtke
F M
FM
Apfel
C C
CC
Kuhly
R
R
Baumeyer
A
A
Brandt
C
C
Wernecke
K D
KD
Spies
C D
CD
D000768:Anesthesia, General; D000932:Antiemetics / Q000627:therapeutic use; D004282:Documentation / Q000379:methods* / Q000592:standards; D005260:Female; D005568:Forms and Records Control; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D009737:Nursing Records / Q000706:statistics & numerical data; D016528:Postanesthesia Nursing / Q000379:methods / Q000592:standards; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D011997:Recovery Room; D011795:Surveys and Questionnaires
D000932:Antiemetics