Intraoperative Electronic Reminder Module to Enhance Postoperative Nausea and Vomiting Prophylaxis
Intraoperative Electronic Reminder Module to Enhance Postoperative Nausea and Vomiting Prophylaxis
This project intends to develop and implement an electronic reminder for post-operative
 nausea and vomiting (PONV) prophylaxis into the Anesthesia Record Keeping System.

 Each patient will have his or her PONV risk classified based on the following risk factors:
 Female gender, History of PONV, History of Motion Sickness, Non-smoker and Duration of
 procedure > 60 minutes.

 Patients will be randomized to either receive the PONV reminder or not. Those receiving the
 PONV reminder will have the PONV risk assessment and current guideline information for PONV
 prophylaxis displayed on the Anesthesia Record Keeping System (ARKS) screen at the beginning
 of the case.

 At the end of the procedure (specific at documentation of emergence), the reminder will
 assess the current status of PONV prophylaxis as per anti-emetic medications administered and
 compare the current status to the recommended status based on published guidelines.

 If the current status is compatible or exceeds the recommended status the reminder will
 silently document compliance.

 If published guidelines suggest additional PONV prophylaxis based on the patients risk
 profile and a comparison with the currently documented status, an electronic reminder will
 appear on the ARKS screen to alert the anesthesia provider of an opportunity to enhance
 guideline adherence.

 The reminder will not recommend a specific medication, intervention or therapy.

 It will be completely the decision of the anesthesia provider if and how to modify the PONV
 prophylaxis for the patient.

 Subjects randomized to not receive the electronic display will have it deactivated.
Each patient will have his or her PONV risk classified based on the following risk factors
 Female gender, History of PONV or Motion Sickness, Non-smoker and Duration of procedure > 60
 min utilizing information already entered into the Anesthesia Record Keeping System. Patients
 having 0-1 risks factors present will be low risk. 2 risks factors present are medium risk
 and more than 2 risk factors present are high risk.

 Patients will be randomized to either receive the PONV reminder or not. Those receiving the
 PONV reminder will have the PONV risk assessment and current guideline information for PONV
 prophylaxis will be displayed on the ARKS screen at the beginning of the case.

 In a second step at the end of the procedure (specific at documentation of emergence), the
 reminder will assess the current status of PONV prophylaxis as per anti-emetic medications
 administered and compare the current status to the recommended status based on published
 guidelines.

 If the current status is compatible or exceeds the recommended status the reminder will
 silently document compliance.

 If published guidelines suggest additional PONV prophylaxis based on the patients risk
 profile and a comparison with the currently documented status, an electronic reminder will
 appear on the ARKS screen to alert the anesthesia provider of an opportunity to enhance
 guideline adherence.

 The reminder will display the PONV risk assessment information, current status of PONV
 prophylaxis as well as the information that current guidelines recommend additional PONV
 prophylaxis.

 The reminder will not recommend a specific medication, intervention or therapy.

 It will be completely the decision of the anesthesia provider if and how to modify the PONV
 prophylaxis for the patient.

 Subjects randomized to not receive the electronic display will have it deactivated.
Inclusion Criteria:

 -  Age ≥ 18 years

 -  Procedure with General Anesthesia

 Exclusion Criteria:

 -  Postoperative admission to the Intensive Care Unit

 -  Postoperative fast-track to Phase II

 -  Patient remains sedated/intubated at the end of the procedure