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AORN Blog - The Periop Life

3 Ways to Apply Complementary Care

Woman breathing through mouth in serene environment.
December 12, 2021

More patients and their surgeons are planning alternative approaches such as aroma and music therapy to manage pain, anxiety, and nausea. Knowledge is the key to making these practices work for your patients.

Patient discomfort is often part of the surgical experience and is usually managed with specific drugs, such as those to reduce anxiety, nausea, and pain. However, there is an uptick in requests for non-pharmacologic solutions to these discomforts and more research is coming out on how these alternative approaches are helping patients.

For example, a 2019 study on non-pharmacologic pain relief found that when nurses implemented postoperative relaxation therapy for patients undergoing abdominal surgery, they were able to achieve pain relief for the patients by reducing patient anxiety and lowering muscle tension.

To learn more about the practical side of applying complementary therapies into practice, we spoke with holistic perioperative care expert Claire Everson, RN, CNOR(e), CCAP. Speaking from her knowledge as a certified aromatherapy practitioner and retired periop educator, Everson works to advance knowledge on holistic approaches to all perioperative nurses.

“As patients and their surgeons are realizing the benefits of complementary care, perioperative RNs need to be educated on the latest evidence to learn the ‘why’ as well as the ‘how’ of these holistic strategies so they can join collaborative efforts to incorporate them into the flow of a patient’s perioperative care experience,” Everson stresses.

Understanding the Evidence Behind Complementary Care

Everson says music therapy, aroma therapy, and guided imagery are just a few of the most common complementary care modalities a patient can choose—and while they aren’t new, there is a large and growing body of research that supports the benefits of adding complementary therapies to a patient’s care plan.

For example, a randomized controlled trial showed that combining citrus essential oil and music therapy reduced post-procedural pain. In a separate study, researchers found that isopropyl alcohol and slow deep breathing reduced postoperative nausea.

Applying A Holistic Approach

Complementary care is most effective when healthcare organizations use an interdisciplinary team to determine when and how the complementary care interventions will be used, Everson explains. And while healthcare professionals can become certified in specific types of complementary care interventions, she says many other potentially effective approaches may also be approved by the healthcare organizations for all perioperative nurses who are educated and hold specific competencies.

That’s why Everson is presenting at AORN Global Surgical Conference & Expo 2022 to share her experiences and implementation tips for incorporating complementary care into periop practice. She gave us a preview of her talk with three important considerations:

  1. Complementary Care Education Should Be Started Preoperatively

Most holistic approaches need to be discussed with the patient ahead of their procedure to confirm patient consent and preferences. This ideally starts by discussing options with the patient and their families as soon as surgery is scheduled and collaborating with the care team as much as possible, Everson explains. “Even if the surgeon does not order any complementary care, patient education ahead of the surgery can be beneficial to help patients understand their holistic options during surgical care.”

  1. Music Therapy Requires More Than Playing the Patient’s Favorite Song

In her work with board certified music therapists, Everson has witnessed first-hand how pre-planning is essential to make this therapy most effective. Careful coordination with the surgical team, especially the anesthesiologist, is key so the patient’s preoperative preparation and musical therapy preparation, such as positioning headphones without hindering team communication with the patient or creating an area of pressure on the patient’s skin.

  1. Aromatherapy Goes Beyond Choosing Something That Smells Nice 

The aromatherapist has taken an intense course and understands that "it is the chemistry of the essential oil that determines its effects," Everson explains. There are several aromatherapy scents that are geared toward specific adverse events, such as nausea or pain, as well as different delivery methods. After the preoperative assessment, the aromatherapist will perform a skin patch test if the essential oil is to be applied topically as a massage or a compress. Because there are several different essential oils that can have similar calming effects, the organization may decide to allow patients to choose the one that is most pleasing if more than one is offered.

Everson will share more of these practical tips at AORN Global Surgical Conference & Expo 2022. Register today to attend her session, “A Holistic Approach to Reduce Patient Anxiety & Post Operative Pain.”

Want to learn more? AORN updated the Guideline for Complementary Care in the 2022 Guidelines for Perioperative Care, which can be pre-ordered now ahead of publication in January.

AORN Global Surgical Conference & Expo. March 19-23, 2022 - New Orleans, LA. Register Now

AORN’s Periop Talk Podcast

Listen to the latest episode featuring Perioperative Practice Specialist and author of the new Guideline on Complementary Care Mary Alice Anderson, PhD, RN, CNOR. She discusses how simple practices can ease patient anxiety and pain.