To decrease patients postoperative ’ nausea and vomiting by using aromatherapy as a comfort measure in addition to antiemetic medications.
Read more: Aromatherapy Blend Program for Postoperative Nausea and VomitingDATE: July 10, 2023
BACKGROUND
Postoperative nausea and vomiting (PONV) are one of the most common complications, which occur between 20% to 50% in general surgery patients and as high as 80% in high-risk populations that can last up to 24 hours after surgery.
The associated risks of uncontrolled PONV — including electrolyte disturbance, wound dehiscence, dehydration, epigastric pain and aspiration pneumonia — can complicate recovery, leading to possible extended PACU stays, higher risk of readmission, and disruptions to the daily lives of discharged patients.
PRACTICE ISSUE
Postoperative Nausea (PON) is one of the most undesirable outcomes after surgery, thus increasing patient dissatisfaction, increasing risk of recovery complications and increasing cost.
OBJECTIVES
The study aimed to achieve several outcomes related to the use of aromatherapy in the treatment of postoperative nausea and vomiting (PONV). First, it sought to increase nurses’ knowledge regarding the effectiveness of aromatherapy in addressing PONV. Second, it aimed to enhance nurses’ self-confidence in utilizing aromatherapy as a comfort measure for PONV. Additionally, the study aimed to decrease the postoperative nausea score among patients and increase their overall satisfaction with the treatment.
METHODS
The research process involved conducting a comprehensive literature review and synthesizing the evidence on aromatherapy for postoperative nausea and vomiting (PONV). A PowerPoint presentation was created to educate PACU nurses about the benefits and application of aromatherapy in PONV management. Subsequently, an Aromatherapy Blend Program was implemented, utilizing a product called QueaseEASE, which consists of a blend of peppermint, spearmint, ginger, and lavender essential oils. This program was specifically designed for adult patients who had undergone general anesthesia and were experiencing PONV at JMH-Miami.
RESULTS
PACU nurses (N = 29) exhibited a substantial increase in aromatherapy knowledge, with the mean pretest score of 3 (50%) rising to a mean post-test score of 5.07 (84.5%). This improvement was statistically significant, as evidenced by a Wilcoxon signed-rank test (W) value of 0.00 and a p-value of < 0.001.
Likewise, nurses’ self-confidence showed a noteworthy increase following the education session, as indicated by a rise in mean self-confidence score from 1.72 to 2.41. This boost in self-confidence was statistically significant (W = 0.00, p < 0.001).
The use of aromatherapy for postoperative nausea and vomiting (PONV) resulted in a decrease in patients’ nausea levels and an increase in patient satisfaction. The mean pre-intervention nausea score of 2.27 decreased to a mean post-intervention score of 0.80 (N = 15), indicating a significant reduction in PONV (W = 91, p < 0.001). Moreover, the mean patient satisfaction score was 2.40 (N = 15), indicating a high level of satisfaction with the Aromatherapy Blend Program (W = 105, p < 0.001).
RESULTS
First, a pre and post-test knowledge questionnaire consisting of six questions was administered to PACU nurses. This questionnaire aimed to evaluate any changes in their knowledge about aromatherapy for PONV. Additionally, a 4-point Likert scale was used to assess the nurses’ self-confidence levels in utilizing aromatherapy as a comfort measure for PONV, both before and after the intervention.
The postoperative nausea score was measured to quantify the severity of nausea experienced by patients after the aromatherapy intervention. A 4-point Likert scale was
utilized to measure patient satisfaction with the Aromatherapy Blend Program. This scale allowed patients to rate their level of satisfaction with their experience, providing valuable feedback on the effectiveness and acceptability of the intervention.
LIMITATIONS
Several limitations were identified in this study. Firstly, the participant size was small, which may limit the generalizability of the findings to a larger population. Additionally, there was a limited supply of the product QueaseEASE, which may have impacted the number of patients who could receive the intervention.
Data collection was incomplete as responses were only collected from 15 out of the total 30 participants. This may introduce a potential bias and affect the overall reliability of the results.
The study did not take into account the risk of PONV when selecting participants. Considering the variability in individual susceptibility to PONV, this factor could have influenced the outcomes.
Lastly, the nurses’ prior knowledge and familiarity with aromatherapy were not factored into the study. This may have influenced their responses, attitudes, and implementation of the Aromatherapy Blend Program.
IMPACT IN PRACTICE
Aromatherapy for PONV offers several benefits. It reduces costs by providing a cost-effective intervention. It enhances recovery by soothing discomfort and promoting relaxation. It aligns with a holistic nursing approach, addressing physical, emotional, and psychological needs. It also promotes autonomy for both nurses and patients, allowing patients to actively participate in their care decisions and empowering nurses to provide individualized care. By incorporating aromatherapy, healthcare can be more cost-effective, recovery can be improved, holistic care can be provided, and autonomy can be promoted.
ACKNOWLEDGEMENT
Jackson Memorial Hospital Perianesthesia staff, Stephanie Carver, BSN, RN- Director of Education, Soothing Scents, Soothing-Scents Company, Shondeen Ramontal-Malcolm, RN, BSN, MPH – Associate, Director of Perianesthesia Department, Marybeth Banciella – ANM/Team leader, Annia Rojas Capote – Nurse Educator/Team leader, Karina Gattamorta, PhD, Renee Longini, DNP, CRNA- Adviser
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