In a descriptive, qualitative study by the University of Colorado comparing QueaseEASE® to alcohol pads, patients and nurses both reported significantly higher satisfaction with QueaseEASE®.
AUTHOR(S): Debra Malone BSN, RN, CAPA
DATE: April 2015
READ THE FULL STUDY BELOW:
PURPOSE
The purpose of this quality improvement study was to compare the patient and provider’s satisfaction with isopropyl alcohol to QueaseEASE® aromatherapy in reducing PONV. A secondary outcome was to evaluate differences in PACU stay times between patients that were given isopropyl alcohol to inhale versus patients given QueaseEASE® aromatherapy to inhale.
METHODS
The design of this project is descriptive and exploratory.
This project was a quality improvement project that evaluated aromatherapy as a complementary therapy for the management of PONV. The team consisted of Anschutz Outpatient Pre-Operative and Post-Anesthesia Care Unit (AOP Pre/ PACU) nurses. All participants were postoperative outpatients with PONV in the AOP PACU. The sample size was 100 patients with PONV. The study was conducted from November 2014 to March 2015.
The patients were all treated with traditional treatment modalities. All the patients received aromatherapy as a complementary therapy modality. The first 50 patients with PONV in the above time period received isopropyl alcohol pads to inhale, and the next 50 patients with PONV received a QueaseEASE® to inhale.
At discharge, the outpatients were sent home with their assigned aromatherapy and instructions on how to use at home if needed. They were also informed they would be asked to rate the helpfulness of the aromatherapy in treating their PONV during their postoperative discharge phone call. The QueaseEASE® pad lasts for 8 hours. An isopropyl alcohol pad dries out in approximately one hour, therefore, additional isopropyl pads were sent home for participants in the isopropyl alcohol group.
During the postoperative follow up phone call, the patient was asked the helpfulness of the aromatherapy in reducing their PONV using a 1-5 scale (with 1 being least helpful, and 5 extremely helpful). Comments were also collected, as well as PACU minutes, gender, age, and type of surgery. At the end of the collection period, the nurses used the same 1-5 scale to rate their overall experience of the helpfulness of using the aromatherapy as a complementary treatment for PONV. Comments were also collected.
RESULTS
N=50. The average score of the isopropyl alcohol pad patient group was 2.54. 16 patients rated it at 1 (least helpful), 7 patients rated it at 2 (slightly helpful), 16 patients rated it at 3 (somewhat helpful), 6 patients rated it at 4 (very helpful), and 5 patients rated it at 5 (extremely helpful).
N=50. The average score of the QueaseEASE® patient group was 3.7. 5 patients rated it at 1 (least helpful), 4 patients rated it at 2 (slightly helpful), 16 patients rated it at 3 (somewhat helpful), 3 patients rated it at 4 (very helpful), and 12 patients rate it at 5 (extremely helpful).
The nurses’ overall satisfaction score for the QueaseEASE® product was 4.1. 0 nurses rate it at 1 (least helpful), 0 nurses rated it at 2 (slightly helpful), one nurse rated it at 1 (somewhat helpful), 11 nurses rated it at 4 (very helpful), and three nurses rated it at 5 (extremely helpful).
The nurses’ overall satisfaction score for the QueaseEASE® product was 4.1. No nurses rated it at 1 (least helpful), no nurses rated it at 2 (slightly helpful), one nurse rated it at 1 (somewhat helpful), 11 nurses rated it at 4 (very helpful), and three nurses rated it at 5 (extremely helpful).
There were no differences in PACU times. The average time for the isopropyl alcohol group was 159 minutes. The average time for the QueaseEASE® group was 156 minutes.
Patients’ ages ranged from 16-72. The average patient age was 45. Of the 100 patients with PONV, 69 were female and 31 were male. Of the 100 patients with PONV, 42 had orthopedic surgery, 26 had ENT surgery, 16 had gynecology surgery, and 15 had a variety of general surgeries.
DISCUSSION
The PONV Aromatherapy Study confirms the majority of both the patient and the nurses felt aromatherapy was somewhat to extremely helpful as a treatment modality for PONV. Satisfaction with the QueaseEASE® by patients was higher (3.7) than with isopropyl alcohol (2.54). The nurses’ satisfaction with QueaseEASE® in reducing patients’ PONV was higher (4.1) than with the isopropyl alcohol pads (2.8). No differences were found between the standard of care group (isopropyl alcohol) and the evidence-based practice group (QueaseEASE®) for the time spent in PACU.
This study did not show any numerical difference in PACU times between the two aromatherapies. It is important to acknowledge other variables that affect PACU times. For instance, pain levels, oxygen saturation levels, sedation levels, the nurse’s workload, the patient’s motivation, transportation arrangements, can all affect the amount of time patients stay in the PACU. How or if these variables contribute to PACU times may be explored in future projects on complementary modalities.
It is well-documented in the literature that women have a higher incidence of PONV and this study’s results were consistent with this finding. No inferential testing was performed, as this study was a pilot study collecting descriptive data. Further analysis will need to be performed in the future to determine any statistical significance in group differences.
The largest surgical procedure group with PONV in the study consisted of patients undergoing orthopedic procedures. Orthopedic surgeries may have been a larger percentage of our total surgical procedures during the study period. Further study in our department should examine if we are giving those undergoing orthopedic procedures effective prophylactic treatment for PONV compared to those undergoing different types of procedures, such as gynecology patients, whom literature has shown has a higher incidence of PONV.
Further study is needed to examine if aromatherapy reduces the amount of antiemetic medications administered in the PACU. A reduced use of antiemetic medication could impact health care expenses and decrease unwanted side effects of these medications.
IMPLICATIONS
This quality improvement project demonstrated that both the patients and the nurses were more satisfied with the QueaseEASE® product in treating and managing PONV in comparison to the current standard of care of using an isopropyl alcohol pad. The evidence-based approach using QueaseEASE® during this project shows promise in reducing PONV among our patients.
Several different units in the hospital have also shown an interest in obtaining this product to help comfort their patients. Many hospitals, including local hospitals, are now offering patients more complementary therapies. Patients at the University of Colorado Hospital may expect to have selections such as aromatherapy offered to them during their stay as well.