Date of this Version

12-4-2024

Document Type

DNP Project

Rights

default

Abstract

Background: Nausea and vomiting are persistent problems faced by patients who undergo

anesthesia and are related to increased hospital costs, staffing needs, and negative surgical

outcomes. Risk factors for post-operative nausea and vomiting (PONV) are female, non-smoking

status, a history of PONV or motion sickness, and postoperative opioid use. Nausea and

vomiting are common adverse effects of spinal anesthesia for women undergoing cesarean

section (CS). Two primary factors are the opioid administration of morphine or fentanyl in the

spinal anesthetic and the sympathetic response from the spinal anesthesia. The sympathectomy

produces profuse hypotension, which in turn leads to nausea and vomiting. While there is no

current guideline to prevent PONV during spinal anesthesia, the application of multimodal

therapy with the utilization of Atropine intrathecal (IT) or intravenous (IV), Ondansetron, and

the aroma of alcohol has shown to be effective at decreasing the incidence of nausea and

vomiting and help blunt the sympathectomy.

Method: After synthesizing a literature review, an education module was developed to educate

providers on the usefulness of Atropine, Ondansetron, and alcohol aroma for PONV prevention

during spinal anesthesia for parturient patients. A survey was made to test participants’

knowledge of PONV prevention and the proposed prevention protocol. A pre-test of 10 questions

was asked, followed by a 5 ½ minute educational PowerPoint presented on the topic, followed by

the same 10 questions as a post-test to assess the knowledge gained by the participants.

Results: Twelve providers consented to participate in the survey created. Ten questions were

asked in the pre- and-post-tests to assess providers' baseline knowledge of PONV, Atropine,

Ondansetron, and alcohol aroma and new knowledge gained by the PowerPoint presentation.

There was a mix of results, as the participants answered 3 more questions on the post-test

correctly compared to the pre-test, demonstrating a growth in educational knowledge. However,

4 questions were answered incorrectly on the post-test compared to the pre-test, revealing a lack

of knowledge growth. Three questions were responded to similarly on the pre-test and post-test.

The pre-test had an accuracy rate of 69.2% of questions answered correctly as opposed to the

post-test, which had an accuracy rate of 67.2% of questions answered correctly.

Discussion: The data collected displays a gap in education between the pre-test and the post-test

and a further need for education on PONV prophylaxis, sympathectomy, spinal anesthesia,

Atropine, Ondansetron, and alcohol aroma. Although some results showed higher accuracy on

certain topics after the educational module, most of the questions answered showed a lack of

understanding.

Download

Share

COinS
 

Rights Statement

Rights Statement

In Copyright. URI: http://rightsstatements.org/vocab/InC/1.0/
This Item is protected by copyright and/or related rights. You are free to use this Item in any way that is permitted by the copyright and related rights legislation that applies to your use. For other uses you need to obtain permission from the rights-holder(s).