Evidence-Based Interventions for Post Discharge Nausea and Vomiting: A Review of the Literature Jan Odom-Forren, MS, RN, CPAN, FAAN Susan J. Fetzer, MBA, PhD, RN Debra K. Moser, DNSc, RN, FAAN Postoperative nausea and vomiting (PONV) and postdischarge nau- sea and vomiting (PDNV) continue to be a problem for one third of all patients who require surgery and anesthesia. Very few studies have been reported that specifically target PDNV in the outpatient surgery population for interventions after discharge home. Twenty studies were identified that specifically addressed the effect of an intervention for the purpose of preventing PDNV or rescuing the patient who develops PDNV. This article presents an integrative review of the research literature to determine the best evidence for prevention of PDNV in adults or for the rescue of patients who suffer from PDNV. © 2006 by American Society of PeriAnesthesia Nurses. POSTOPERATIVE nausea and vomiting (PONV) continues to be a problem in the post- anesthesia setting for one third of all patients who require surgery and anesthesia. 1-5 The in- cidence can be as high as 70% to 80% among patients with predetermined risk factors. 6 Un- fortunately, as many as 30% to 50% of outpa- tients will continue to struggle with post dis- charge nausea and vomiting (PDNV) after their arrival home. 3,7,8 With more than 60% to 65% of all surgeries performed currently in the ambu- latory surgery setting, thousands of patients ex- perienced PDNV. 9 PONV and PDNV are not conditions that typically contribute to mortality; however, it has been called the “big little prob- lem” 10 because of patient aversion to nausea and vomiting, the effect on quality of recovery, the potential for morbidity and hospitalization in high-risk patients, and the loss of patient satisfaction. Investigators have focused on assessment of the patient risk for PONV. 11,12 In one study, a risk assessment using only four or five factors was determined as effective at predicting nausea and vomiting as tools that used as many as 13 criteria. 11 Other studies have focused on the effects of anesthetic agents or other medica- tions on the incidence and severity of PONV. 13,14 Prophylactic use of antiemetics has been considered, as well as the most effective timing of the administration of those antiemet- Jan Odom-Forren, MS, RN, CPAN, FAAN, is a perianesthesia nursing consultant, Louisville, KY, and is a PhD student at the University of Kentucky, College of Nursing, Lexington, KY; Sue Fetzer, MBA, PhD, RN, is Associate Professor and Director, RN Baccalaureate Program, University of New Hampshire, School of Health and Human Services, Durham, NH; and Debra K. Moser, DNSc, RN, FAAN, is Professor and Gill Chair of Nursing, University of Kentucky, College of Nursing, Lexington, KY. Address correspondence to Jan Odom-Forren, MS, RN, CPAN, FAAN, 800 Edenwood Circle, Louisville, KY 40243; e-mail address: jodom29373@aol.com. © 2006 by American Society of PeriAnesthesia Nurses. 1089-9472/06/2106-0006$32.00/0 doi:10.1016/j.jopan.2006.09.001 Journal of PeriAnesthesia Nursing, Vol 21, No 6 (December), 2006: pp 411-430 411