An integrative process: acupressure to prevent and treat postoperative nausea and vomiting in patients undergoing abdominal surgery

Abstract

Problem Statement: Postoperative nausea and vomiting (PONV) continues to be problematic for surgical patients despite use of new-generation antiemetics. Purpose: This project was designed to bridge a knowledge gap for nursing staff by providing education on the implementation of acupressure at P6, assisting them in implementing this intervention, and analyzing the results. Methods: A survey of surgical nurses revealed an interest and lack of knowledge in acupressure implementation. Education for nurses was provided on the use of acupressure at P6 to prevent PONV. The implementation of acupressure by nursing staff was then assessed with a pilot study using a non-blinded, randomized controlled design. Jean Watson's Human Caring Theory and the Integrative Healthcare principles served as theoretical foundations for this project. Surgical patients undergoing abdominal surgery at risk for PONV were randomized to either the acupressure treatment group (acupressure and routine antiemetics) or control group (routine antiemetics only). Nausea and vomiting were rated using the PONV intensity scale and a Verbal-Rating scale. Nurse and patient attitudes toward holistic health and complementary and alternative healthcare were assessed, as well as patient perceptions of nurses' level of caring using the Caring Factor Scale. Analysis: Statistical analysis included Welch's two-sample t-test, Wilcoxson's Rank Sum Test, repeated measures ANOVA, and descriptive statistics. Results: Participants who received acupressure experienced less PONV, but this was not statistically significant. Those who received acupressure required more antiemetic medications, which marginally increased their healthcare cost. Participants who received acupressure had a significant improvement in CAM attitudes, but there were no differences in how patients perceived the level of care from nursing staff between groups. Significance: The results of this study provide evidence for the feasibility of nurse-implemented acupressure for PONV, and clinically significant data to promote use of acupressure at P6 to prevent and treat PONV. Future qualitative research regarding patient and nurse experiences with acupressure would add to the already extensive quantitative data available.