Postoperative Management of PONV

Application: Creating a Flowchart

Workflow analysis aims to determine workflow patterns that maximize the effective use of resources and minimize activities that do not add value. There are a variety of tools that can be used to analyze the workflow of processes and clarify potential avenues for eliminating waste. Flowcharts are a basic and commonly used workflow analysis method that can help highlight areas in need of streamlining.

In this Assignment, you select a common event that occurs regularly in your organization and create a flowchart representing the workflow. You analyze the process you have diagrammed and propose changes for improvement.

To prepare:

Identify a common, simple event that frequently occurs in your organization that you would like to evaluate. (PONV in Phase I & phase II) Flow chart is attached that will be used

Consider how you would design a flowchart to represent the current workflow.

Consider what metrics you would use to determine the effectiveness of the current workflow and identify areas of waste.

To complete:

Write a 3- to 5-page paper which includes the following:

Create a simple flowchart of the activity you selected.

Next, in your paper:

Explain the process you have diagrammed.

For each step or decision point in the process, identify the following:

Who does this step? (It can be several people.)

What technology is used?

What policies and rules are involved in determining how, when, why, or where the step is executed?

What information is needed for the execution of this step?

Describe the metric that is currently used to measure the soundness of the workflow. Is it effective?

Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow.

Summarize why it is important to be aware of the flow of an activity.

Remember to include a cover page, introduction, and summary for your paper.

Postoperative Management of PONV

Rectangle: Rounded Corners: AromatherapyRectangle: Rounded Corners: Very adequate hydrationRectangle: Rounded Corners: Select & Administer appropriate anti-emetic
Zofran, Reglan, Phenergan
,
Rectangle: Rounded Corners: Implement anti-emetic Rectangle: Rounded Corners: Give anti-emetic that impacts diff. receptor site than prophylactic agentRectangle: Rounded Corners: YesRectangle: Rounded Corners: NORectangle: Rounded Corners: Did patient receive prophylactic anti-emetic agentRectangle: Rounded Corners: Quantify SeverityRectangle: Rounded Corners: Continue to monitorRectangle: Rounded Corners: YesRectangle: Rounded Corners: NoRectangle: Rounded Corners: Nausea/VomitingRectangle: Rounded Corners: Postoperative Management of PONV: Phase I and Phase II PACU

Postoperative Management of PONV

Introduction

            Since the 1990s, attention has increasingly been concentrated on PACUs (Postanesthesia Care Unit) as a result of the dramatic improvement as far as patient care in operating rooms is concerned. In the US, more than forty million patients are operated every year. Globally, over 100,000,000 patients undergo the same where about thirty percent of these experience PONV (postoperative nausea and vomiting), which is an adverse anesthesia effect that is reported commonly. Even patients having zero recognized risk factors have a ten percent risk factor of experiencing PONV. There is a dramatic increased risk to 61 percent and 79 percent in that order where there are three or four risk factors (nonsmoker, female gender, postoperative opioid use, motion sickness history, and a PONV history (Keyes, 2013). PONV adverse effects range from postoperative morbidity to patient-related distress. Its effects are critical, which warrants for immediate treatment.

The process

            Following surgery, a patient may or may not experience postoperative nausea and vomiting and its management in the PACU encompasses of phase one and two. If a patient fails to experience nausea and vomiting, he should be monitored keenly. In patients who experience the two, the severity should be quantified, and further management is based on if the patient did or did not get prophylactic anti-emetic agent. If the patient received, he should be given an anti-emetic whose effects is on different receptor sites compared to prophylactic agents. After this, together with patients who did not receive the anti-emetic, the anti-emetic should be implemented after which there should be very sufficient hydration, aromatherapy, and selection and administration of proper anti-emetic Phenergan, Reglan, and Zofran (Keyes, 2013).

Who does this step?

The first step is accomplished by the anesthesiologist and operating room team. The nurse monitors the patient’s dressings, surgical site, tubes, and drains. The nurse also monitors the nausea and medicates accordingly. The doctor also monitors the patient regularly.

Technology

The patient is provided with the PCA (Patient Control Analgesia Pump that is useful in pain control and a specialized monitoring equipment may be ordered by the doctor if necessary.

What policies and rules are involved in determining how, when, why, or where the step is executed?

During the first phase, the patient’s oxygen levels, respiration rate, heart rate, blood pressure, and temperature determine many of the steps that are implemented. It is also very important to estimate every patient’s PONV risk. The medical consequences risks following vomiting should also be assessed (Keyes, 2013).

What information is needed for the execution of this step?

The bedside examination information excluding mechanical factor and initiating medication is essential in executing the step. Some of the contributing factors include morphine with patient-controlled analgesia, blood drainage in the throat, and gut obstruction. After mechanical factors and medication are excluded, there can be initiation of the rescue anti-emetic therapy.

Describe the metric that is currently used to measure the soundness of the workflow. Is it effective?

A postoperative assessment is very essential in ensuring patient recovery. However, there are several quality metrics that can be used by the professionals. The time spent in recovery as well as temperature on arrival is vital components of the experience and they are easy to quantify. Incision pain, patient’s stability and the level of nausea and vomiting should be assessed.

Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow

When administering anti-emetic agents in adults, there is a need to combine them in high-to-moderate risk patients so as to avoid PONV effectively. Combining transdermal scopolamine and ondansetron can confer more benefits to the patients that are considered at high to moderate risk for PONV (Sweis, Yegiyants & Cohen, 2013).

Summarize why it is important to be aware of the flow of an activity

It is extremely important that the healthcare professionals involved in the care of the patient in PACU are aware of the flow of activities as outlined in the diagram. If the professionals possess this information, the patient’s care becomes easy since the professional is already aware of what he should do. Knowing the flow of activities is very handy in case of emergencies as the professionals take the appropriate measure immediately.

Conclusion

            PONV is very vital in preventing the impacts that are associated with nausea and vomiting including significant postoperative discomfort, increased pulmonary aspiration incidence, unanticipated hospital admission, and delayed PACU discharge (Kovac, 2013).  It is very important that professionals in PACU are able to identify the high-risk patients so that they can be put on prophylactic intervention. This goes a long way in improving patient care quality and satisfaction in PACU.

References

Kovac, A. L. (2013). Update on the management of postoperative nausea and vomiting. Drugs, 73, 14, 1525-47.

Sweis, I., Yegiyants, S. S., & Cohen, M. N. (2013). The management of postoperative nausea and vomiting: current thoughts and protocols. Aesthetic Plastic Surgery, 37, 3, 625-33.

Keyes, M. (2013). Management of postoperative nausea and vomiting in ambulatory surgery: the big little problem. Clinics in Plastic Surgery, 40, 3, 447-52.

Application: Creating a Flowchart

Workflow analysis aims to determine workflow patterns that maximize the effective use of resources and minimize activities that do not add value. There are a variety of tools that can be used to analyze the workflow of processes and clarify potential avenues for eliminating waste. Flowcharts are a basic and commonly used workflow analysis method that can help highlight areas in need of streamlining.

In this Assignment, you select a common event that occurs regularly in your organization and create a flowchart representing the workflow. You analyze the process you have diagrammed and propose changes for improvement.

To prepare:

Identify a common, simple event that frequently occurs in your organization that you would like to evaluate. (PONV in Phase I & phase II) Flow chart is attached that will be used

Consider how you would design a flowchart to represent the current workflow.

Consider what metrics you would use to determine the effectiveness of the current workflow and identify areas of waste.

To complete:

Write a 3- to 5-page paper which includes the following:

Create a simple flowchart of the activity you selected.

Next, in your paper:

Explain the process you have diagrammed.

For each step or decision point in the process, identify the following:

Who does this step? (It can be several people.)

What technology is used?

What policies and rules are involved in determining how, when, why, or where the step is executed?

What information is needed for the execution of this step?

Describe the metric that is currently used to measure the soundness of the workflow. Is it effective?

Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow.

Summarize why it is important to be aware of the flow of an activity.

Remember to include a cover page, introduction, and summary for your paper.

Postoperative Management of PONV

Rectangle: Rounded Corners: AromatherapyRectangle: Rounded Corners: Very adequate hydrationRectangle: Rounded Corners: Select & Administer appropriate anti-emetic
Zofran, Reglan, Phenergan
,
Rectangle: Rounded Corners: Implement anti-emetic Rectangle: Rounded Corners: Give anti-emetic that impacts diff. receptor site than prophylactic agentRectangle: Rounded Corners: YesRectangle: Rounded Corners: NORectangle: Rounded Corners: Did patient receive prophylactic anti-emetic agentRectangle: Rounded Corners: Quantify SeverityRectangle: Rounded Corners: Continue to monitorRectangle: Rounded Corners: YesRectangle: Rounded Corners: NoRectangle: Rounded Corners: Nausea/VomitingRectangle: Rounded Corners: Postoperative Management of PONV: Phase I and Phase II PACU

Postoperative Management of PONV

Introduction

            Since the 1990s, attention has increasingly been concentrated on PACUs (Postanesthesia Care Unit) as a result of the dramatic improvement as far as patient care in operating rooms is concerned. In the US, more than forty million patients are operated every year. Globally, over 100,000,000 patients undergo the same where about thirty percent of these experience PONV (postoperative nausea and vomiting), which is an adverse anesthesia effect that is reported commonly. Even patients having zero recognized risk factors have a ten percent risk factor of experiencing PONV. There is a dramatic increased risk to 61 percent and 79 percent in that order where there are three or four risk factors (nonsmoker, female gender, postoperative opioid use, motion sickness history, and a PONV history (Keyes, 2013). PONV adverse effects range from postoperative morbidity to patient-related distress. Its effects are critical, which warrants for immediate treatment.

The process

            Following surgery, a patient may or may not experience postoperative nausea and vomiting and its management in the PACU encompasses of phase one and two. If a patient fails to experience nausea and vomiting, he should be monitored keenly. In patients who experience the two, the severity should be quantified, and further management is based on if the patient did or did not get prophylactic anti-emetic agent. If the patient received, he should be given an anti-emetic whose effects is on different receptor sites compared to prophylactic agents. After this, together with patients who did not receive the anti-emetic, the anti-emetic should be implemented after which there should be very sufficient hydration, aromatherapy, and selection and administration of proper anti-emetic Phenergan, Reglan, and Zofran (Keyes, 2013).

Who does this step?

The first step is accomplished by the anesthesiologist and operating room team. The nurse monitors the patient’s dressings, surgical site, tubes, and drains. The nurse also monitors the nausea and medicates accordingly. The doctor also monitors the patient regularly.

Technology

The patient is provided with the PCA (Patient Control Analgesia Pump that is useful in pain control and a specialized monitoring equipment may be ordered by the doctor if necessary.

What policies and rules are involved in determining how, when, why, or where the step is executed?

During the first phase, the patient’s oxygen levels, respiration rate, heart rate, blood pressure, and temperature determine many of the steps that are implemented. It is also very important to estimate every patient’s PONV risk. The medical consequences risks following vomiting should also be assessed (Keyes, 2013).

What information is needed for the execution of this step?

The bedside examination information excluding mechanical factor and initiating medication is essential in executing the step. Some of the contributing factors include morphine with patient-controlled analgesia, blood drainage in the throat, and gut obstruction. After mechanical factors and medication are excluded, there can be initiation of the rescue anti-emetic therapy.

Describe the metric that is currently used to measure the soundness of the workflow. Is it effective?

A postoperative assessment is very essential in ensuring patient recovery. However, there are several quality metrics that can be used by the professionals. The time spent in recovery as well as temperature on arrival is vital components of the experience and they are easy to quantify. Incision pain, patient’s stability and the level of nausea and vomiting should be assessed.

Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow

When administering anti-emetic agents in adults, there is a need to combine them in high-to-moderate risk patients so as to avoid PONV effectively. Combining transdermal scopolamine and ondansetron can confer more benefits to the patients that are considered at high to moderate risk for PONV (Sweis, Yegiyants & Cohen, 2013).

Summarize why it is important to be aware of the flow of an activity

It is extremely important that the healthcare professionals involved in the care of the patient in PACU are aware of the flow of activities as outlined in the diagram. If the professionals possess this information, the patient’s care becomes easy since the professional is already aware of what he should do. Knowing the flow of activities is very handy in case of emergencies as the professionals take the appropriate measure immediately.

Conclusion

            PONV is very vital in preventing the impacts that are associated with nausea and vomiting including significant postoperative discomfort, increased pulmonary aspiration incidence, unanticipated hospital admission, and delayed PACU discharge (Kovac, 2013).  It is very important that professionals in PACU are able to identify the high-risk patients so that they can be put on prophylactic intervention. This goes a long way in improving patient care quality and satisfaction in PACU.

References

Kovac, A. L. (2013). Update on the management of postoperative nausea and vomiting. Drugs, 73, 14, 1525-47.

Sweis, I., Yegiyants, S. S., & Cohen, M. N. (2013). The management of postoperative nausea and vomiting: current thoughts and protocols. Aesthetic Plastic Surgery, 37, 3, 625-33.

Keyes, M. (2013). Management of postoperative nausea and vomiting in ambulatory surgery: the big little problem. Clinics in Plastic Surgery, 40, 3, 447-52.

Application: Creating a Flowchart

Workflow analysis aims to determine workflow patterns that maximize the effective use of resources and minimize activities that do not add value. There are a variety of tools that can be used to analyze the workflow of processes and clarify potential avenues for eliminating waste. Flowcharts are a basic and commonly used workflow analysis method that can help highlight areas in need of streamlining.

In this Assignment, you select a common event that occurs regularly in your organization and create a flowchart representing the workflow. You analyze the process you have diagrammed and propose changes for improvement.

To prepare:

Identify a common, simple event that frequently occurs in your organization that you would like to evaluate. (PONV in Phase I & phase II) Flow chart is attached that will be used

Consider how you would design a flowchart to represent the current workflow.

Consider what metrics you would use to determine the effectiveness of the current workflow and identify areas of waste.

To complete:

Write a 3- to 5-page paper which includes the following:

Create a simple flowchart of the activity you selected.

Next, in your paper:

Explain the process you have diagrammed.

For each step or decision point in the process, identify the following:

Who does this step? (It can be several people.)

What technology is used?

What policies and rules are involved in determining how, when, why, or where the step is executed?

What information is needed for the execution of this step?

Describe the metric that is currently used to measure the soundness of the workflow. Is it effective?

Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow.

Summarize why it is important to be aware of the flow of an activity.

Remember to include a cover page, introduction, and summary for your paper.

Postoperative Management of PONV

Rectangle: Rounded Corners: AromatherapyRectangle: Rounded Corners: Very adequate hydrationRectangle: Rounded Corners: Select & Administer appropriate anti-emetic
Zofran, Reglan, Phenergan
,
Rectangle: Rounded Corners: Implement anti-emetic Rectangle: Rounded Corners: Give anti-emetic that impacts diff. receptor site than prophylactic agentRectangle: Rounded Corners: YesRectangle: Rounded Corners: NORectangle: Rounded Corners: Did patient receive prophylactic anti-emetic agentRectangle: Rounded Corners: Quantify SeverityRectangle: Rounded Corners: Continue to monitorRectangle: Rounded Corners: YesRectangle: Rounded Corners: NoRectangle: Rounded Corners: Nausea/VomitingRectangle: Rounded Corners: Postoperative Management of PONV: Phase I and Phase II PACU

Postoperative Management of PONV

Introduction

            Since the 1990s, attention has increasingly been concentrated on PACUs (Postanesthesia Care Unit) as a result of the dramatic improvement as far as patient care in operating rooms is concerned. In the US, more than forty million patients are operated every year. Globally, over 100,000,000 patients undergo the same where about thirty percent of these experience PONV (postoperative nausea and vomiting), which is an adverse anesthesia effect that is reported commonly. Even patients having zero recognized risk factors have a ten percent risk factor of experiencing PONV. There is a dramatic increased risk to 61 percent and 79 percent in that order where there are three or four risk factors (nonsmoker, female gender, postoperative opioid use, motion sickness history, and a PONV history (Keyes, 2013). PONV adverse effects range from postoperative morbidity to patient-related distress. Its effects are critical, which warrants for immediate treatment.

The process

            Following surgery, a patient may or may not experience postoperative nausea and vomiting and its management in the PACU encompasses of phase one and two. If a patient fails to experience nausea and vomiting, he should be monitored keenly. In patients who experience the two, the severity should be quantified, and further management is based on if the patient did or did not get prophylactic anti-emetic agent. If the patient received, he should be given an anti-emetic whose effects is on different receptor sites compared to prophylactic agents. After this, together with patients who did not receive the anti-emetic, the anti-emetic should be implemented after which there should be very sufficient hydration, aromatherapy, and selection and administration of proper anti-emetic Phenergan, Reglan, and Zofran (Keyes, 2013).

Who does this step?

The first step is accomplished by the anesthesiologist and operating room team. The nurse monitors the patient’s dressings, surgical site, tubes, and drains. The nurse also monitors the nausea and medicates accordingly. The doctor also monitors the patient regularly.

Technology

The patient is provided with the PCA (Patient Control Analgesia Pump that is useful in pain control and a specialized monitoring equipment may be ordered by the doctor if necessary.

What policies and rules are involved in determining how, when, why, or where the step is executed?

During the first phase, the patient’s oxygen levels, respiration rate, heart rate, blood pressure, and temperature determine many of the steps that are implemented. It is also very important to estimate every patient’s PONV risk. The medical consequences risks following vomiting should also be assessed (Keyes, 2013).

What information is needed for the execution of this step?

The bedside examination information excluding mechanical factor and initiating medication is essential in executing the step. Some of the contributing factors include morphine with patient-controlled analgesia, blood drainage in the throat, and gut obstruction. After mechanical factors and medication are excluded, there can be initiation of the rescue anti-emetic therapy.

Describe the metric that is currently used to measure the soundness of the workflow. Is it effective?

A postoperative assessment is very essential in ensuring patient recovery. However, there are several quality metrics that can be used by the professionals. The time spent in recovery as well as temperature on arrival is vital components of the experience and they are easy to quantify. Incision pain, patient’s stability and the level of nausea and vomiting should be assessed.

Describe any areas where improvements could occur and propose changes that could bring about these improvements in the workflow

When administering anti-emetic agents in adults, there is a need to combine them in high-to-moderate risk patients so as to avoid PONV effectively. Combining transdermal scopolamine and ondansetron can confer more benefits to the patients that are considered at high to moderate risk for PONV (Sweis, Yegiyants & Cohen, 2013).

Summarize why it is important to be aware of the flow of an activity

It is extremely important that the healthcare professionals involved in the care of the patient in PACU are aware of the flow of activities as outlined in the diagram. If the professionals possess this information, the patient’s care becomes easy since the professional is already aware of what he should do. Knowing the flow of activities is very handy in case of emergencies as the professionals take the appropriate measure immediately.

Conclusion

            PONV is very vital in preventing the impacts that are associated with nausea and vomiting including significant postoperative discomfort, increased pulmonary aspiration incidence, unanticipated hospital admission, and delayed PACU discharge (Kovac, 2013).  It is very important that professionals in PACU are able to identify the high-risk patients so that they can be put on prophylactic intervention. This goes a long way in improving patient care quality and satisfaction in PACU.

References

Kovac, A. L. (2013). Update on the management of postoperative nausea and vomiting. Drugs, 73, 14, 1525-47.

Sweis, I., Yegiyants, S. S., & Cohen, M. N. (2013). The management of postoperative nausea and vomiting: current thoughts and protocols. Aesthetic Plastic Surgery, 37, 3, 625-33.

Keyes, M. (2013). Management of postoperative nausea and vomiting in ambulatory surgery: the big little problem. Clinics in Plastic Surgery, 40, 3, 447-52.

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