Predictors of Postoperative Nausea and Vomiting in Neurosurgical Patients.

In the neurosurgery patient population, one of the most frequent complications is postoperative nausea and vomiting (PONV). The purpose of this predictive correlational study was to examine the incidence and predictors of PONV in a cohort of 519 neurosurgery patients undergoing elective spinal and intracranial procedures. Patients were interviewed, and their medical records were reviewed every 24 hours for up to 72 hours postoperatively to identify risk factors for PONV development. After summarizing univariate associations, a multivariable logistic regression model for each outcome was developed using forward and backward stepwise selection, with the p value for a variable to enter or leave the model set to .05. Women, especially those who were younger and with a history of PONV, were most likely to have PONV. In addition, those undergoing craniotomy, particularly infratentorial craniotomy, were more likely to have PONV compared with patients undergoing spine surgery. This study provides a foundation for nursing and interdisciplinary intervention studies aimed at reducing this postoperative symptom in the most susceptible patients.

Mayo Clinic Reduces Catheter-Associated Urinary Tract Infections Through a Bundled 6-C Approach.

The primary CAUTI reduction strategies of ensuring aseptic technique during catheter placement and reducing urinary catheter utilization were already in place at our institution. A multidisciplinary team approach, which entailed the use of QI methodology and engagement of frontline staff, resulted in the identification of additional strategies to reduce CAUTI. By implementing these strategies, we successfully reduced CAUTIs and have sustained this reduction through March 2016. The tools created during this project can be easily adapted for use at other institutions.