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.
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.
PACU Start 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:
Not applicable
All providers for a given case who are signed in ≥ 40 minutes. If a given case is ≤ 60 minutes, all providers are responsible.
Antiemetic
Class: 5-Hydroxytryptamine (5-HT3) Receptor Antagonists
Antihistamines
Butyrophenones
Benzamides
Neurokinin-1 Receptor Agonists
Phenothiazines
Prokinetic
PONV Outcomes
Measure Start
Date Reviewed | Reviewer | Institution | Summary | QC Vote |
---|---|---|---|---|
9/26/2022 |
Patricia Mack |
Weill Cornell Medical Center |
Modify |
Date | Criteria | Revision |
---|---|---|
07/26/2022 | Success | Added Amisulpride as antiemetic |
11/11/2021 | Exclusion | Added Radiation Oncology room tag as exclusion |
03/25/2021 | Multiple | Modified Measure End, PACU Start; Labor Epidural exclusion now uses Obstetric phenotype |
08/04/2020 | Success | Modified to use note entered time if observed time is not available |
01/13/2020 | Success | Modified to use Antiemetic Class phenotype to determine medications used |
12/09/2019 | Success | Removed Methylprednisolone from list of medications |
11/22/2019 | Exclusion | Cases converted to c-section now override labor epidural exclusion |
11/11/2019 | Success | Removed Dexamethasone from list of medications |