Evidence-based Guideline of Using Aromatherapy in Relieving Postoperative Nausea and ...

87 Pages·2014·0.51 MB·English

Abstract of thesis entitled
Evidence-based Guideline of
Using Aromatherapy in Relieving
Postoperative Nausea and Vomiting

Submitted by
Yip Sau Chun

for the degree of Master of Nursing
at The University of Hong Kong
in August 2014

Postoperative nausea and vomiting (PONV) is a prevailing problem noted
among surgical patients. It is noted that PONV induces a number of physical and
psychological problems which increases patients' suffering and their stay in
hospital. In order to prevent and relief PONV, most surgical patients in Hong
Kong are prescribed with antiemetic mediation. However, these antiemetic
mediations have some adverse effects and may not be able to relief PONV.
Aromatherapy is an alternative possible strategy to manage patients with PONV.
Therefore, a comprehensive literature review is done on aromatherapy on
surgical patients who encounter postoperative nausea and vomiting. Appropriate
studies are found in 6 databases including Pubmed, Medline(1950-Aug 2013),
Cochrane Library, CINAHL (1984-Aug 2013), British Nursing Index and Achieve
(1985-Aug 2013) and EMBASE (1947-Aug2013). A total of 7 randomized
controlled trails are reviewed. Data are extracted from these articles and analyzed.
An evidence-based guideline of aromatherapy on relieving postoperative nausea
and vomiting is developed. The feasibility, transferability, implementation
potential and strategies are discussed in this dissertation. Moreover, an evaluation
plan is made to ensure the effective application of aromatherapy in adult surgical
patients with PONV in a public hospital in Hong Kong. It is anticipated that
aromatherapy can help to reduce psychological and physiological distress that
induced by PONV of surgical patients. Also, by introducing an evidence-based
guideline, the sense of autonomy of nurses is developed which facilitate nursing
advancement.
Evidence-based Guideline of
Using Aromatherapy in Relieving
Postoperative Nausea and Vomiting

by
Yip Sau Chun

A thesis submitted in partial fulfillment of the requirements
for
the degree of Master of Nursing
at The University of Hong Kong
August 2014
Declaration
I declare that this thesis thereof represents my own work, except where due
acknowledgement is made, and that it has not been previously included in a thesis,
dissertation or report submitted to this University or to any other institution for a
degree, diploma or other qualifications.

Signed______________________________
Yip Sau Chun

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Acknowledgements
I would like to express my sincere gratitude and deepest appreciation to my
supervisor, Dr Athena Hong, for her enlightenment, encouragement, guidance and
support over the past two years.

Lastly, I am grateful to all of those who supported me in any respect during
the completion of the thesis.

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Contents
Declaration …………………………………………………………………………………i
Acknowledgements ………………………………………………………………………ii
Table of Content …………………………………………………………………………iii
List of Appendices ………………………………………………………………………vii

Chapter 1 - Introduction ……………………………………………………………… 1
1.1 Background
1.2 Affirming the Need
1.3Significance and Objectives of the Study
1.3.1 Research Question

Chapter 2 - Critical Appraisal ……………………………………………………… 8
2.1 Searching Strategies
2.1.1 Identification of Studies
2.1.2 Inclusion Criteria
2.1.3 Exclusion Criteria
2.1.4 Data Extraction
2.2 Appraisal Strategies
2.3 Summary and Synthesis of Results
2.3.1 Patient Characteristics
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2.3.2 Intervention used
2.3.3 Length of Follow Up
2.3.4 Outcome Measure
2.4 Synthesis of Data
2.4.1The Population
2.4.2 The Outcome Measures
2.4.3 The Effects of Intervention
2.4.4 Summary of Synthesis
2.5 Methodological Quality of the Studies
2.5.1 Studies' Characteristics
2.5.2 Allocation of Participants
2.5.3 Binding
2.5.4 Conclusion accounted from all Participants
2.5.5 Incomplete Outcome Data
2.5.6 Minimize the Play of Chance
2.5.7 Precision of the Results of Study
2.5.8 Applicability of Findings
2.5.9 Level of Evidence

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Chapter 3 – Translation and Application ……………………………………… 22
3.1 Implementation Potential
3.1.1 Target setting
3.1.2 Target Client
3.1.3Transferability of the Findings
3.1.3.1 Target setting and client
3.1.3.2 Philosophy of care
3.1.3.3 Time frame
3.2 Feasibility
3.2.1 Freedom in the implementation
3.2.2 Interference of current staff function
3.2.3 Administrative support
3.2.4 Potential conflict or friction
3.2.5 Staff training
3.2.6 Equipment and facilities
3.2.7 Potential risk and benefits
3.3 Cost-benefit ratio of the innovation
3.3.1 Potential risks and benefits towards patients
3.3.2 Potential risks and benefits towards staff
3.3.3 Potential risks and benefits towards hospital

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Chapter 4 – Evidenced-based Guideline ………………………………………… 30
4.1 Evidence-based guideline
4.2 Purpose of protocol
4.3 Target Client of protocol
4.4 Implementation of program
4.5 Clinical Guideline
4.6 Practice Recommendations

Chapter 5 – Implementation Plan ………………………………………………… 33
5.1 Communication Plan
5.1.1 Identification of stakeholders
5.1.2 Communication Process and Implementation Strategies
5.1.2.1 Advanced Practice Nurse in Surgical Units
5.1.2.2 Department Operating Manager and Ward Manager of Surgical
Units
5.1.2.3 Continuous Quality Improvement Committee for management of
postoperative nausea and vomiting
5.1.2.4 Nurses in Surgical Units
5.1.2.5 Resident Doctors
5.2 Pilot Testing Plan
5.2.1 Objectives
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5.2.2 Time frame, target population, sample size and target setting
5.2.3 Outcome measures
5.2.4 Acceptability and feasibility assessment
5.2.5 Discussion about the data collected from the pilot study

Chapter 6 – Evaluation Plan ……………………………………………………… 47
6.1 Outcome Identification
6.1.1 Patient Outcome
6.1.2 Staff and System Outcome
6.2 Design of Innovation
6.3 Outcome Measurement
6.4 Data Analysis
6.5 Effectiveness of Innovation
6.5.1 Patient clinical outcomes
6.5.2 Nursing compliance.
6.5.3 Patient and staff satisfactory level
6.5.4 Measures to sustain the change of practice

Chapter 7 - Conclusion ……………………………………………………………… 47
Appendices …………………………………………………………………………… 64
References ……………………………………………………………………………… 73
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