ASPAN National Conference Abstracts

RESEARCH POSTER ABSTRACTS

INTERIM ANALYSIS OF THE PRE-OPERATIVE INCENTIVESPIROMETRY EDUCATION (POISE) INTERVENTIONCarole Bergin, RN, CAPA, Karen Kelly, BSN, RN, ONC,

Tom Travis, MS, RRT-NPS, RCP,

Karen Gabel Speroni, BSN, RN, MHSA, PhD

Inova Fair Oaks Hospital, Fairfax, VA

Introduction: Pre-operative incentive spirometry (IS) education effects on

post-operative outcomes are not well documented.

Identification of the Problem: Achieving effective inspiration sooner

post-operatively may decrease post-operative pulmonary complications and

length of stay.

Study Purpose: Determine the effect the POISE intervention has on post-op-

erative outcomes for patients undergoing knee or hip total joint replacement.

Methodology: Prospective study of 100 total joint patients randomized to

Group 1 (POISE) or Group 2 (no intervention). Subjects are followed thru

discharge to determine time for return to baseline IS volume. Data collection in-

cludes demographics, comorbidities, and length of stay. Scripted pre-operative

education is provided for patients on IS use, practice and levels documentation.

Results: The majority of the 69 subjects (Group 1 5 34; Group 2 5 35), were

Caucasian (Group 1 5 94%; Group 2 5 86%) females (Group1 5 62%; Group

2 5 60%); average age was 61-64 years. Group 1 had faster IS baseline vol-

umes at Days 3 and 4 (Group 1 5 97% & 100%; Group 2 5 82.9% &

97.1%), fewer post-operative pulmonary complications, and shorter LOS

(Group 1 5 2.44 days; Group 2 5 2.66).

Conclusion: The POISE intervention is an easy, inexpensive method to

improve surgical patient post-operative outcomes.

POSTDISCHARGE NAUSEA AND VOMITING (PDNV):INCIDENCE IN ADULT SURGICAL OUTPATIENTSCatherine C. Capitula, RN, CAPA, Halya M. Hebert, BSN, RN

Seton Health/St. Mary’s Hospital, Troy, NY

Introduction/Problem: PDNV remains a problem for 30-50% of all patients

who receive general inhalation anesthesia during surgery and are discharged

home the same day. Over 34 million persons have outpatient surgery annually

in the U.S. and are at risk for PDNV.

Purposes: The purposes of this study were: 1) to determine the incidence

and severity of PDNV in outpatients receiving general inhalation anesthesia

at Seton Health; 2) to evaluate self care of PDNV; and 3) to look for correlations

between the postoperative nausea and vomiting (PONV) risk score and PDNV.

Methodology: A convenience sample of 339 patients who received general in-

halation anesthesia over a six month period was surveyed. Data were collected

using a structured survey; 41 % of the patients returned the survey (n 5 144).

Descriptive statisticswere used to quantitatively summarize the data; inferential

statistics were used to identify trends in the outpatient surgical population.

Results/Discussion: The incidence of PDNV was experienced by 33% (n 5

46) with an average severity rating of , 2 on a 0-10 Likert Scale. Episodes of

vomiting were reported by 13% of patients. Lying down proved to be the

most used self care activity in the treatment of PDNV reported by 23%. Of

those that used self care activities to treat their PDNV 77% felt they did not

work. No significant correlation was found between the PONV risk score

and the actual experience of PDNV.

Conclusions/Implications: The findings of this study provide another layer

on the thin foundation of the topic of PDNV. Based on these findings, the next

layer for exploration is to examine the relationship of post op pain medications

and PDNV. Evaluating the scope of the problem leads to identification of modifi-

able risk factors and successful treatment modalities with interventions for post

anesthesia care nurses to implement at Seton Health.

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THE EFFECT OF REIKI ON WOMEN’S PREOPERATIVEANXIETY IN AN AMBULATORY SURGERY CENTERNatalie Cassidy, BSN, RN, Kristin Collins, BSN, RN, Donna Cyr, BSN, RN,

Katie Magni, MSN, RN

Salem State College, Beverly Hospital at Danvers/Northeast Health

System

Preoperative anxiety is a widely recognized phenomenon in the surgical set-

ting. Women have been found to suffer a higher incidence of preoperative

anxiety than men. Patients can experience an increase in heart rate, blood

pressure, and pain. The purpose of this study was to explore the effect of Re-

iki on preoperative anxiety in women undergoing ambulatory surgery proce-

dures. An experimental design was used; 20 patients received Reiki with

music, and 18 patients in the control group received music only. Target pop-

ulation included women between the ages of 18-59. The results showed Reiki

to be statistically significant on heart rate, systolic blood pressure, and anxi-

ety scales in preoperative women as compared to music alone. In recent

years, patients have expressed an interest in using a more holistic approach

using complementary alternative modalities along with pharmacological

therapy. Reiki is a form of touch therapy that is low cost and easily imple-

mented by certified practitioners. Therefore, Reiki could be utilized as a com-

plementary therapy in the preoperative area to help alleviate anxiety. Nurses

in particular are in a unique position to provide low cost, patient centered

alternative interventions. Further research is needed to evaluate the effect

of Reiki on patient satisfaction.

Keywords: Reiki, preoperative anxiety, music therapy.

PERI-OPERATIVE MUSIC TO DECREASE ANXIETYBrenda Johnson, RN, CPAN, (Presenter)

Shirley Raymond, RN, BSN, CPAN,

Judy Goss, RN, BSN, Kim Latham, RN, BSN, CCRN, Dianne Stapp, RN,

Lisa Haubner, RN, Joyce Burke, RN, BES, CPAN

The Christ Hospital, Cincinnati, OH

Literature supports use of music to reduce stress and anxiety. Ambient

noise of monitors, other patients, and staff may elevate levels of anxiety.

The purpose was to determine if music or noise-blocking headphones

will decrease anxiety more than a control group in women undergoing

GYN SDS. IRB approval was obtained. The women were approached for

consent prior to pre-op medication and were randomized to usual care,

music with headphones, or headphones only. Pre-operative anxiety was

obtained using the Rapid Anxiety Assessment tool which rates anxiety on

a scale of 0-10.This tool has been validated by Benotsch et al. (2000).

Both interventions were started in SDS prior to pre-operative medications.

Music or headphones were continued throughout surgery and removed

when Aldrete LOC 5 2. Post-op anxiety was then rated. The 119 women

enrolled in the study had a mean age of 38.8 (sd 5 2.2) years. Of interest,

51 reported very low pre-operative anxiety (0-3/10) and were excluded.

There was no significant difference by group (p . .05). All groups experi-

enced a drop in anxiety from pre to post-operative status but the controls

had the least (F 5 3.5, p 5 .03, power 5 0.63). Music had the most

improvement followed by headphones. Music is an inexpensive interven-

tion, easy to administer, and noninvasive. It offers patients a coping strategy

giving them a sense of control over an unfamiliar environment. Use of

music can be a valuable tool in creating a restful PACU environment to

decrease anxiety and promote healing.

Journal of PeriAnesthesia Nursing, Vol 25, No 3 (June), 2010; pp 196-198