13 de dezembro de 2011

Artigo recomendado: ASPAN’S Evidence-Based Clinical Practice Guideline for the Prevention and/or Management of PONV/PDNV

Journal of PeriAnesthesia Nursing, Vol 21, No 4 (August), 2006: pp 230-250

Problem: Postoperative and post-discharge nausea and vomiting (PONV/PDNV) is one of the most commonly occurring postoperative complications, frequently resulting in prolonged postoperative stay, unanticipated admission and increased health care costs. Yet, health care providers have yet to reach consensus regarding an evidence-based multi-disciplinary, multi-model treatment approach to PONV/PDNV.

Purpose: To develop a multi-modal, multi-disciplinary evidence-based resource for anesthesia providers and nurses involved in the care of patients in inpatient and outpatient settings who are having procedures performed in the operating room, as well as in other locations where sedation or anesthesia may be administered, who are at risk for, or experiencing PONV and/or PDNV.

Method: ASPAN organized a Strategic Work Team (SWT) consisting of 18 multi-disciplinary, multi-specialty experts charged with the review and analysis of published evidence related to the prevention and/or management of PONV/PDNV. The evidence was summarized and presented at a consensus conference in March, 2006, with small group discussions among participants to critique and stratify all available evidence. Consensus based decision making techniques were then used to establish multi-disciplinary, multi-modal evidence-based recommendations regarding risk factor identification and stratification, traditional (pharmacological, hydrations, NPO status, etc) and complimentary (acustimulation, aromatherapy, etc) treatment modalities.

Results: One hundred percent consensus was reached on all guideline recommendations. Multi-disciplinary, multi-modal evidence-based recommendations were made regarding risk factor identification and stratification, traditional, and complimentary prophylaxis and management of PONV/PDNV. Areas of needed research in the prevention and management of PONV/PDNV were also identified and prioritized.

Implications for Practice: Translation of this multi-disciplinary, multi-modal evidence-based practice guideline into practice to direct the prevention and/or management of PONV/ PDNV should improve health outcomes in adult surgical patients.

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