EBP Project Made Easy with Plant Therapy Smellease
Determine the patient population you would like to implement aromatherapy with and why. Form your PICOT Question: Population, Intervention, Control, Outcome, Time
Examples:
In Adult PostOP patients (P), how does aromatherapy(I), compared with no aromatherapy(C) affect nausea and vomiting(O) in recovery(T)?
In emergency department patients (P), does aromatherapy (I) decrease anxiety (O) when compared with standard care (C) while waiting to be treated (T)?
Consider forming a team to collect and review the evidence. (examples of who might make up team: Shared Governance Council members, journal club members, resource nurses, nursing professional development nurses and nurse educators, Magnet Coordinator)
2. Acquire Evidence- utilize your institutions medical library to review current literature on the use of aromatherapy (or have your librarian search on your behalf). Below are the doi numbers to recent articles to help you get started. (we could put this table at the end- depending on what looks best visually)
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Article |
Location |
Conclusion |
|---|---|---|
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Aromatherapy in Nursing and Midwifery Practice: A Scoping Review of Published Studies Since 2005 |
The evidence supports the use of aromatherapy within a range of nursing and midwifery practices enhancing a holistic model of care. |
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The effect of aromatherapy on fatigue in adults receiving hemodialysis treatment: A systematic review and meta-analysis of randomized controlled trials. |
DOI: 10.1111/jan.14922 |
Aromatherapy has a high and positive effect on fatigue in the adult’s receiving hemodialysis and can be used as an effective intervention in the management of fatigue. |
|
Effects of Lavender on Anxiety, Depression, and Physiological Parameters: Systematic Review and Meta-Analysis |
Confirmed the results of existing reviews on the effect of inhalation and massage applicating lavender essential oil for a significant decrease in anxiety levels |
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Establishing a Comprehensive Aromatherapy Program in Patient Care Settings. |
Aromatherapy is a safe, cost-effective, nonpharmacologic, evidence-based nursing intervention that can be offered in conjunction with other methodologies for relief of pain, nausea, and anxiety and to enhance well-being. |
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A systematic literature review and meta-analysis of the clinical effects of aroma inhalation therapy on sleep problems |
Inhalation aromatherapy is effective in improving sleep problems such as insomnia |
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Effects of Peppermint Aromatherapy on Postoperative Nausea and Vomiting |
The peppermint aromatherapy was favorably received by many of the postoperative patients and may be an effective adjunct treatment with antiemetics for PONV |
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Clinical Aromatherapy |
Aromatic scents and oils used in clinical aromatherapy can be beneficial for symptom management such as pain, nausea, vomiting, anxiety, depression, stress, insomnia, agitation with dementia, cancer pain, and end of life symptoms, Clinical aromatherapy has been found beneficial in the inpatient and outpatient settings especially critical care, oncology, palliative care, hospice, and surgical. |
3. Evaluate the Evidence- Determine the evidence based on your intended use. At Orlando Health (OH), Plant Therapy’s Clinical Partners, Smellease is used for Anxiety, Pain, Nausea and Vomiting, insomnia and dialysis fatigue in adult populations. You may want to create a table of Evidence to assess your findings and support your plans for implementation. There are many resources available on how to effectively table evidence.
4. Implementation- When implementing aromatherapy into your practice there are many things to consider, such as how you will measure the effectiveness of the implementation, does your organization use a model for implementation (such as a PDSA model), and do you require oversight or approval of any governing body (ie- Shared Governance, Nursing Leadership, etc) before you start? Make sure you inquire and design your implementation around your organization’s structures. Below are steps of implementation used at Orlando Health in the pilot phase of implementation.
Determine how to measure effectiveness. OH implemented the pilot in the perioperative areas of pre-op and PACU. Effective measures were nurse reports and EHR documentation Other metrics to consider could include patient experience metrics, patient testimonials, length of stay, agitation scales, and others depending on your selected population.
Educate your nursing team about the pilot and determine when your go-live will begin. At OH education was accomplished with in-services during daily huddles and handouts to reinforce the teachings were hung in appropriate areas in the unit. The go-live and planning details were further discussed in Shared Governance meetings, at unit staff meetings and in the EBP and Research Council meetings.
Determine how to educate your patients- OH approached this several ways. Since the implementation was in a perioperative setting, education began in pre-operative testing with verbal description of aromatherapy as a complementary therapy option and as a handout in pre-operative paperwork. Education was also given verbally and in print if requested in Pre-op before patients were sedated. (We can attach the education pieces here as examples if we want)
Determine the location of your product and how to document its use and patient response- At OH the SDS (and formulary? Not my specialty) sheets were reviewed by the Pharmacy and determined to be safe for clinical use. It was decided that the aromatherapy packets would be kept in a cabinet in the nurse’s station. Initially they were stocked by the nurse leader, but eventually the Materials department stocked them.
Document use and patient response. At OH Nursing Informatics built a simple flowsheet for nurses to document use and response. It may be a free text in a determined field, or you may have an appropriate place in the EHR already. This should be part of the nursing education before implementing. Consider how to assess patients’ response. OH determined to assess 15 minutes after patient use.
Don’t forget your providers. It is vital to have providers that understand and support the implementation. Include your providers in the in-services, offer them samples to try. Show them your evidence table.
Order the Smellease -When you order Smellease from Plant Therapy there is no contract! Additionally, you can order smaller amounts, just enough for your EBP project.
5. Evaluate the Implementation – After your desired time frame (OH used a 3-month time frame), evaluate the project. What were the outcomes of the measures you initially decided on? How did the nurses embrace the change? If using a PDSA model you may find at this point you need to redesign and do another cycle. If all went well as planned -continue with the aromatherapy practice and consider expanding into other departments.
6. Disseminate your results- Showing off is fun! Make a poster, submit an abstract, or at minimum report the success of your project to all the stakeholders, any applicable councils or professional development events at your organization. Don’t forget to tell us here at Plant Therapy as well. We can’t wait to hear your success stories.
Alison Ruiz, MSN, RN, CCRN-K, NPD-BC
Kelly Kollstedt, MSN, RN, CNOR
For additional information feel free to contact us at wholesale@planttherapy.com