Pediatric Postoperative Nausea and Vomiting: Assessing the Impact of Evidence-Based Practice Change.

Postoperative nausea and vomiting (PONV) is an unpleasant complication following anesthesia and surgical procedures experienced by both adults and children. Compared with adults, children are 2 times more likely to experience PONV. Many studies have identified and independently validated risk factors associated with the development of PONV in the pediatric population. Chief among these are patient age greater than 3 years, surgical duration greater than 30 minutes, surgical type, and a history of PONV. The purpose of this evidence-based practice change was to investigate if preoperative documentation of a patient's PONV history will lower PONV rates postoperatively. A PONV history assessment tab was created to aid in the documentation of the patient's PONV history, and a retrospective chart review was conducted 2 months before and 2 months after the practice change. A total of 2,279 preintervention cases were compared with 2,006 postintervention cases. Rates of PONV dropped 22%, from 153 preintervention cases to 120 postintervention cases, demonstrating a significant (P = .0043) decrease in PONV rates following a patient's reported history of PONV. Documentation of a patient's PONV history preoperatively led to a decrease in postoperative rates of PONV.