Thursday, May 01, 2008

Vickie's Research Corner

Welcome to Vickie’s Research Corner. Spring has sprung and so have many research projects here at St. Joseph Hospital. I would like to introduce you to Lorilee Amlie, the new Nurse Navigator for Melanoma. Lorilee has been with the hospital for many years and used to work in the Outpatient Surgery Center in the Pavilion. She has a very exciting study called “Post-Operative Nausea and Vomiting Chart Review.”

What is your study about?
My study was to identify medical record findings for ambulatory surgery patients who have received intra-operative or post-operative doses of Zofran. I wanted to look at the effects of antiemetics and to determine how many times this antiemetic is given in the OR.

Is it EBP/Research study?
Research study- Retrospective chart review.

What made you interested in this project?
Since I was in graduate school for nursing administration, I was looking for a research project for my Masters in Nursing. Dr. Rutledge brought this project to me two years ago since I worked in outpatient surgery. Initially in surgery there had been a chart review done by someone else who was trying to identify if certain patients had nausea after surgery, especially with certain anesthesiologists. Once I saw the study I realized this was a good idea. Dr. Rutledge and I decided to look at the effects of the drugs themselves, how often antiemetics (specifically Zofran or Ondansetron) were being given, and if they were being ordered as to the recommendations of current guidelines. I know that nausea is a problem and I wanted to see if we could decrease the amount of nausea that patient’s have pre and post-operatively. According to the literature postoperative nausea and vomiting is a distressing, uncomfortable situation that can increase pain and time in the PACU and sometimes leads to unplanned hospitalizations.

How did you go about your research?
For school I had to write the first three chapters of a thesis, which included a literature review. I examined postoperative nausea and vomiting, medication effects, and recommendations of using drugs. Then I had to go through the IRB at SJH and CSUF. Initially my study was rejected with suggestions from the SJH IRB. After making the adjustments I resubmitted and was accepted. After IRB I began to do chart reviews. With the help of the nursing research staff, who helped me to set up a data collection sheet, I collected all my data. We then put it into a database format and Dr. Rutledge ran the statistics in SPSS for me. I then worked on a poster with more excellent input and help from Dr. Rutledge and you. My poster was disseminated at the Induction Ceremony for Sigma Theta Tau and I was inducted into Upsilon Beta, Sigma Theta Tau International Honor Society.

What are your expected outcomes?
Actually, I expected that patients who received Zofran in both the OR and PACU and who experienced nausea would spend more time in the PACU, my study showed a slight difference between these patients, but it wasn't significant. But, my study did show that those who received Zofran 30 minutes prior to the end of the case spent on average 30 minutes less time in the PACU.

Have you done research before? If so what did you learn?
Nope, never. I learned how important and exciting research could be. I also learned that research is very time consuming. The only real negative part for me was when the IRB initially rejected my study but then when they accepted it I felt fabulous. One great thing about research is when you see the results of your research it’s so much fun.

Will you do research/project again?
I hope so. I met with Maria Gonzales in Oncology and saw all the research projects going on in Oncology. Since I am now the Nurse Navigator for Melanoma I will be working on a research project just on Melanoma.


Julie Smith, MLS, AHIP said...

I really enjoy learning about staff's first hand experiences through the research process!!


Victoria Morrison, RN, MSN, FNP said...