Postoperative Nausea and Vomiting Risk Assessment Audit

Free projects are complete and ready to use. Paid projects can also be adapted to your local requirements. This project uses a fixed Lazomis clinical configuration of 40 audit criteria across cohort and procedure context, PONV risk factor assessment, risk categorisation and communication, prophylaxis and risk reduction, rescue planning and postoperative assessment, treatment, response and escalation, day surgery, recovery and discharge, and handover, records and governance. Data collection, dashboards, findings, improvement planning, re-audit and every output are included at no cost.

• Anaesthetists, anaesthesia associates and perioperative teams
• Recovery, day surgery and ambulatory unit nursing teams
• Clinical pharmacists and enhanced recovery leads
• QI, clinical governance and trainees needing ARCP-ready evidence

• Measure whether PONV risk is assessed and categorised before or during anaesthesia
• Review whether prophylaxis and risk-reduction strategies are matched to documented risk
• Review postoperative assessment, rescue treatment and reassessment of response
• Review the impact of PONV on discharge, unplanned admission and patient information
• Generate governance-ready and ARCP-ready evidence

• Anonymised case number, care setting, specialty, procedure category and anaesthetic technique
• Age band, sex, smoking status, previous PONV or motion sickness and anticipated opioid use
• Risk tool used, documented risk category, prophylaxis given and rescue plan
• PONV occurrence, severity, treatment, response, discharge impact and take-home antiemetic
• 40 fixed audit criteria (Yes / No / Not applicable)
• Free-text learning points

• Live dashboard
• Audit report (Word)
• Executive summary (Word)
• Excel workbook
• PowerPoint presentation
• Conference poster
• ARCP evidence summary

This ready-built project is developed using the guidance, standards and authoritative sources listed below, so you can see what is being measured and why. Lazomis QI does not publish or own this guidance, and inclusion here does not imply endorsement or approval by any of these organisations.

• Society for Ambulatory Anesthesia

  Fourth Consensus Guidelines for the Management of Postoperative Nausea and Vomiting(opens the original source in a new tab)

  Internationally used consensus guidance on PONV risk assessment, risk-adapted prophylaxis and rescue treatment.

• Royal College of Anaesthetists

  GPAS Chapter 2: Perioperative Care of Elective and Urgent Care Patients(opens the original source in a new tab)

  Service standards for perioperative assessment, anaesthetic planning and recovery care.

• Royal College of Anaesthetists

  GPAS Chapter 6: Guidelines for the Provision of Day Surgery Services(opens the original source in a new tab)

  Standards for day surgery selection, recovery, discharge criteria and management of complications including PONV.

• Centre for Perioperative Care and British Association of Day Surgery

  Guidelines for Day Case Surgery(opens the original source in a new tab)

  National guidance on day surgery pathways, recovery, discharge readiness and postoperative symptom management.

• NICE

  NG197: Shared decision making(opens the original source in a new tab)

  Relevant where discussion of PONV risk and management options forms part of perioperative communication.

• NICE

  CG138: Patient experience in adult NHS services(opens the original source in a new tab)

  Relevant where patient experience of nausea, vomiting and recovery information is assessed.

• Designed to use anonymised or pseudonymised audit identifiers.
• This tool supports, but does not replace, clinical judgement.
• Local policy, formulary and specialist advice should be followed.
• Organisations remain responsible for local governance arrangements.
• This tool supports clinical audit and quality improvement. It does not replace clinical judgement, local policy, specialist advice or urgent escalation pathways.
• This is not an antiemetic prescribing guideline. It does not specify drug choices, doses, combinations or thresholds — local policy and formulary apply.
• Persistent, severe or refractory PONV, aspiration risk, dehydration or surgical concern should be managed through local urgent escalation pathways.
• Local anaesthesia, antiemetic, day surgery, recovery, enhanced recovery, discharge and escalation policies should be followed.
• Use anonymous case identifiers only — never patient-identifiable information.

Supporting guidance from the Lazomis QI Resource Library. Authoritative clinical standards referenced by this project remain separate.

• Clinical GovernanceLeveraging Incident Themes for Quality Improvement and Patient SafetyThis guide helps NHS teams identify and analyse recurring incident themes, transforming reported safety events into practical quality improvement opportunities to enhance patient safety and system reliability.
• Clinical GovernanceIntegrating Quality Improvement into Clinical Governance FrameworksThis article explores the vital relationship between Quality Improvement (QI) and Clinical Governance within the NHS, demonstrating how they are two sides of the same coin when aiming for continuous, systematic improvement in patient care.
• Patient SafetyIntegrating Patient Safety and Quality Improvement: A Practical Guide for UK CliniciansThis guide explains the foundational principles of patient safety and quality improvement (QI) within the UK healthcare context, offering practical strategies for clinicians to enhance safety and improve care delivery.
• Patient SafetyHow to Select a Patient Safety Quality Improvement ProjectThis guide helps NHS teams identify and select patient safety quality improvement (QI) projects that are impactful, achievable, and aligned with organisational and national priorities. Learn how to move from identifying concerns to choosing a focused and measurable project.