Phase 2: Preparation

Develop strategies to use enablers and address barriers identified in Phase 1.

Bottom Line In this phase, the team turns Phase 1 findings into actionable plans: selecting the right intervention, determining timing, identifying suitable patient groups, revising hospital guidelines, and assigning clear roles. Thorough preparation is what separates a successful rollout from a stalled pilot.

In this Phase, the team will develop strategies to use enablers and address barriers identified in Phase 1.

Key Phase 2 Items

Identify appropriate timing for acupuncture/acupressure intervention
Revise or update hospital guidelines
Identify and revise relevant documents
Determine each team member's role (using CFIR framework)
Define suitable patient types and surgical procedures
Address identified barriers
Determine intervention delivery personnel based on timing

Feasibility of the Selected Intervention

FAME Criteria

References the FAME criteria (Feasibility, Appropriateness, Meaningfulness, Effectiveness) developed by Pearson et al. (2005).

Feasibility: Can it be done in this setting with available resources?
Appropriateness: Does it fit the clinical context and patient population?
Meaningfulness: Is it valued by patients and clinicians?
Effectiveness: Does the evidence support clinical benefit?

Assessment concludes that "acupressure is a feasible, appropriate, meaningful and effective intervention that should be implemented for PONV."

Identify the Time Point for Introducing Acupuncture

Timing Considerations

Intervention timing depends on purpose: prevention requires pre-operative or immediate post-operative application, while management occurs after symptoms appear.

Acupuncture is "often provided 30 min prior to surgery" or potentially 12–24 hours beforehand, with timing influenced by staff availability and surgical scheduling.

Types of Patients and Surgery

Patient Risk Factors

High-risk PONV indicators include:

Female gender
Prior PONV or motion sickness history
Non-smoker status
Younger age

Surgery types with elevated risk include:

Cholecystectomy
Gynecological procedures
Laparoscopic procedures

Hospital Guidelines and Documentation

Implementation Requirements

Integrating acupuncture or acupressure into hospital practice typically requires:

Hospital PONV guidelines revision
PONV checklists
Patient education materials
Operative and ward documentation updates
Drug chart modifications

Address Barriers

Primary Barriers Identified

Four key obstacles:

Lack of awareness regarding existing evidence
Insufficient capability
Equipment unavailability
Time constraints

Phase 2 Resources

Last reviewed: April 2026