Background: The most frequent, adverse postoperative complications today are postoperative nausea and vomting (PONV), viewed as the most stressful side effects of anesthesia. The use of complementary alternative medicine (CAM) has increased significantly in Western countries, particularly in the United States. The Institute of Medicine reports CAM is more socially, medically and politically accepted than ever before. The Pericardium Six Accupressure Wristband (P6AW) is a CAM technique designed and utilized to reduce PONV. Compelling scientific research findings from randomized control trials support the use of the P6AW to manage PONV. The two-fold focus of this Capstone project was to educate health care team members regarding the CAM method and to implement a practice change for the anesthesia care provider, by adding the P6AW as an option to the preoperative protocol. Foreground: Today, healthcare budgets are decreasing while costs are increasing. The American Hospital Association reported that hospitals are increasingly adding CAM practices to conventional services. A practice change of adding an economical, noninvasive and non-pharmacologic alternative to reduce PONV is a positive step to confronting the healthcare crisis. Methods: This anesthesia problem was addressed at a rural hospital, where data was collected from the existing perioperative quality assurance (QA) survey indicating a 30% PONV occurence rate. After delivering educational in-services and one-on-one demonstrations a pilot study was conducted using the P6AW on consenting anesthesia patients as an adjunct to manage PONV. Evidence Based Practice Framework: The Model for Change, developed by Rosswurm and Larrabee, was chosen to provide a pragmatic strategic six-step guide for this evidence-based practice change. This Capstone project had three objectives; Innovation-by providing evidence on the benefits of the P6AW to reduce PONV; Resource Efficiency-implementing the P6AW option into the anesthesia protocol used as a cost effective adjunct to reduce PONV and; Collaboration-enhanced dialogue between all stakeholders to improve the quality of care and satisfaction by reducing PONV. The two outcomes measured were the frequency of P6AW use and PONV occurrences. Findings: The results of the Needs Assessment correlated with the universal 30% occurrence rate of PONV. The collected data from the pilot study revealed 89% of patients used the P6AW implemented by the anesthesia providers with a decreased incidence of PONV from 30% to 18%. Conclusion: This project was designed to enhance the knowledge to expand proficient management of PONV. This Capstone project generated an increased awareness of the anesthesia complications of nausea and vomiting and explored the challenge of an evidence-based system change implementing an economical CAM technique without compromising outcomes or safety.
