This measure is calculated based on data extracted from the electronic medical record combined with administrative data sources such as professional fee and discharge diagnoses data. This measure is explicitly not based on provider self-attestation.
PONV 03: Percentage of patients, regardless of age, who undergo a procedure and have a documented nausea/emesis occurrence OR receive a rescue antiemetic in the immediate postoperative period.
PONV 03b: Percentage of patients, regardless of age who undergo a procedure and have a documented nausea/emesis occurrence with or without receiving an antiemetic in the immediate postoperative period.
Recovery Room In through 6 hours after Anesthesia End
Patient does not report nausea, have an emesis event or receive an antiemetic during the immediate postoperative period.
Algorithm for determining Measure Start Time:
*If Patient out of Room is used as Measure Start, the measure will begin 1 minute after Measure Start time.
Algorithm for determining Case Duration:
Case Start:
Case End:
All providers for a given case who are signed in ≥ 40 minutes. If a given case is ≤ 60 minutes, all providers are responsible.
Antiemetic MPOG Concept IDs (by class) |
|
Class: 5-Hydroxytryptamine (5-HT3) Receptor Antagonists |
|
10335 |
Ondansetron |
10164 |
Dolasetron |
10208 |
Granisetron |
10711 |
Palonosetron |
Antihistamines |
|
10257 |
Dimenhydrinate |
10160 |
Diphenhydramine |
Butyrophenones |
|
10169 |
Droperidol |
10210 |
Haloperidol |
Neurokinin-1 Receptor Agonists |
|
10035 |
Aprepitant |
10719 |
Fosaprepitant |
Phenothiazines |
|
10374 |
Promethazine |
10373 |
Prochlorperazine |
Prokinetic |
|
10297 |
Metoclopramide |
PONV Outcomes MPOG Concept IDs: |
|
50227 |
GI – Symptoms |
50636 |
Misc - Patient Vomiting |
50219 |
Emesis Occurrence |
10503 |
Emesis |
90010 |
PONV Assessment |
90371 |
Postoperative Nausea and/or Vomiting |
90009 |
PONV Interventions |
Measure Start MPOG Concept IDs |
|
50008 |
AACD Patient Out of Room Date/Time |
50010 |
AACD Recovery Room In Date/Time |
50066 |
Phase I Recovery Room In Date/Time |
50068 |
Phase II Recovery Room In Date/Time |
50379 |
Monitoring - Automated Physiologic Data Capture Stopped |
Postoperative nausea and vomiting (PONV) is a common and unpleasant outcome of anesthesia care that can lead to other complications, lengthening the patient’s recovery period after surgery. Effective management of PONV leads to optimal patient outcomes and comfort during the postoperative period. The Apfel score is one of the most common risk predictors for PONV and is based on 4 variables: female gender, non-smoking status, history of PONV or motion sickness and postoperative opioid administration. The presence of each additional risk factor increases a patient’s risk of PONV by twenty percent. Although including a prophylactic anti-emetic administration protocol that considers such risk factors has shown to reduce the incidence of PONV, there is high variability in this outcome. For the purpose of this measure, PONV is defined as administering any rescue medication (antiemetic MPOG Concepts in table below) or documentation of nausea or vomiting in the immediate postoperative period.
Not applicable