Student Research Symposium Program Portal: Submission #150

Abstract Postoperative nausea and vomiting (PONV) remain significant contributors to delayed recovery, prolonged post anesthesia care unit (PACU) stays, and reduces patient satisfaction. Evidence-based guidelines recommend dexamethasone as part of a multimodal PONV prevention strategy, yet many anesthesia providers remain hesitant to use it in diabetic patients due to concerns about hyperglycemia and surgical site infection (SSI). This quality improvement project sought to address these concerns through targeted education and will measure the success of the intervention by evaluating changes in provider perceptions. The PICO question was: In adult general surgical patients with diabetes (P), compared to non-diabetic patients (C), are those treated prophylactically for PONV (I) less likely to receive IV dexamethasone (O)?
A pre and post educational intervention was conducted at a large tertiary hospital in the southeastern United States. Evidence-based posters summarizing current dexamethasone recommendations were displayed in high-traffic operating room areas. Pre- and post-intervention surveys assessed provider concerns, baseline practices, and likelihood of using dexamethasone in diabetic patients; responses were analyzed descriptively. Seventeen anesthesia providers completed both surveys.
Results showed a 16.2% reduction in concern about hyperglycemia and a 14.7% reduction in concern about SSI after dexamethasone use, along with a small (1.18%) increase in reported likelihood of administering dexamethasone to diabetic patients. Although changes in attitudes were modest, the reduction in perceived risks indicates a positive shift toward evidence-based practice. These findings support continued education on PONV guidelines and suggest dexamethasone remains an appropriate option for diabetic patients when routine postoperative glucose monitoring is in place.