Postoperative Nausea & Vomiting

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July 2020
Home Periop Nursing > Perioperative Practice > Postoperative Nausea & Vomiting

Hospital-wide ERAS adoption hinges on leadership support

Enhanced Recovery After Surgery (ERAS) is arguably the greatest advancement in surgery in the last 20 years. But even healthcare leaders who support the use of ERAS to achieve better outcomes can find it daunting to implement the protocols throughout their hospital systems. Standardizing practices across areas that have historically…

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By: OR Manager
May 12, 2020
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Overcoming common obstacles to implementing a perioperative surgical home

Over the last 5 years, the perioperative surgical home (PSH) model has attracted increasing interest from OR directors, anesthesiologists, and surgeons. This team-based, patient-centered approach coordinates all phases of surgical care, from preoperative assessment through intraoperative care and postdischarge recovery. According to the American Society of Anesthesiologists, PSH initiatives have…

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By: OR Manager
March 16, 2020
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Develop standard work for successful ERAS implementation

At Virginia Commonwealth University (VCU) Health System in Richmond, implementation of Enhanced Recovery After Surgery (ERAS) incorporates principles of Lean thinking, a management methodology that emphasizes “…maximize[ing] customer value while minimizing waste. Simply, lean means creating more value for customers with fewer resources,” according to the Lean Enterprise Institute.1 Several…

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By: OR Manager
January 13, 2020
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Mayo Clinic Care Network reduces hospital stays with ERPs

Editor's Note An Enhanced Recovery Pathway (ERP) created by the Mayo Clinic’s colorectal surgery service a decade ago has now been adopted by other surgical services in seven medical centers that are members of the Mayo Clinic Care Network, the October 15 Harvard Business Review reports. The ability of each…

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By: Judy Mathias
October 24, 2019
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Editorial

Our series on Enhanced Recovery After Surgery (ERAS), which began last month with an overview of its history and perioperative pathway, continues in this issue with examples of improved outcomes and the roles played by perioperative team members (see p 18). ERAS, known to speed recovery and increase patient satisfaction,…

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By: Elizabeth Wood
October 21, 2019
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Identifying postop complications using EHR data and machine learning

Editor's Note Using machine learning on electronic health record (EHR) postoperative data linked to the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) outcomes data, researchers developed a model with 163 predictors of postoperative complications at the University of Colorado Hospital. Of 6,840 patients analyzed with the…

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By: Judy Mathias
October 10, 2019
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Enhanced Recovery After Surgery: The new standard for perioperative care

Enhanced Recovery After Surgery (ERAS®) is a comprehensive, multifaceted, and multidisciplinary approach to the care of the surgical patient. ERAS bundles evidence-based elements to facilitate a faster recovery with fewer complications.1 Spanning the continuum of perioperative care, ERAS elements include: • patient engagement and education • preoperative optimization of nutrition…

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By: OR Manager
September 23, 2019
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OR leaders see benefits of briefer NPO period

Though long fasting before a surgical procedure is tied to increased patient risks, the outdated guideline of NPO after midnight continues to be practiced by many healthcare organizations. In 1999, the American Society of Anesthesiologists (ASA) revised their fasting guidelines to clear liquids up to 2 hours before surgery and…

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By: Judith M. Mathias, MA, RN
May 17, 2019
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Innovative use for drug reduces postop nausea and vomiting

Editor's Note An innovative use for a known drug, amisulpride, is showing promise as an effective treatment for preventing postoperative nausea and vomiting (PONV), finds this study. Amisulpride works by blocking dopamine signaling in the body. A total of 1,147 patients undergoing general anesthesia, who had three or four PONV…

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By: Judy Mathias
March 16, 2018
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Opioid-free general anesthesia reduces postop nausea

Editor's Note Eliminating opioids from general anesthesia is safe and effective and significantly decreases postoperative nausea, finds this study presented October 23 at the Anesthesiology 2017 annual meeting in Boston. Of 1,009 patients who received general anesthesia without opioids, only 11% experienced postoperative nausea--typically 50% to 80% of patients have…

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By: Judy Mathias
October 24, 2017
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