Aromatherapy has made its way into hospital settings, thanks to its dramatic increase in popularity among healthcare consumers.
“Aromatherapy is an effective adjunct intervention that helps promote the comfort of patients who are suffering from post-operative or other instances of nausea and anxiety,” says Stephanie Carver, RN, director of education at Soothing Scents. Carver notes that essential oil interventions are a game-changer for patients and nurses, particularly in a climate where nurses are overworked and patient experience of care is a top concern. She discusses the growing use of aromatherapy in clinical settings, the essential benefits for patients, nurses, and hospitals, and the importance of establishing industry standards and safety practices around this exciting therapeutic intervention.
Q: Tell us more about aromatherapy as an intervention, the evidence behind it, and how it's currently used in medical settings.
Carver: Aromatherapy uses essential oils, a pure aromatic liquid that remains after the distillation or the pressing of plant material. Aromatherapy is one of the fastest-growing complementary care interventions in the United States, with thousands of hospitals using it to promote patient comfort for nausea and anxiety. Patients typically inhale essential oils through a suitable delivery system, which is considered the safer and more widely practiced method for administering aromatherapy in a clinical setting. When a patient inhales an essential oil vapor with specific properties, those molecules are rapidly transported to the limbic brain and can impact the mind and the body in various ways, depending on the chemical composition of the plant extracts selected. For example, lavender helps calm nerves, and ginger, when combined with the high alcohol content of the oils, can interrupt the nausea cycle. Many studies, including evidence-based clinical trials, support the efficacy of this inhaled form of aromatherapy, which we refer to as therapeutic inhaled essential oils (TIEO). In a recent study conducted at Kaiser Permanente Fontana Medical Center in California, 58 post-operative patients experiencing discomfort associated with post-operative nausea were given the Soothing Scents QueaseEASE quick tab aromatherapy intervention. The results showed that 72.4% of the patients stated QueaseEASE completely resolved their nausea, 67% required no additional antiemetics, and the trial also demonstrated a 22% reduction in the post-anesthesia care unit (PACU) length of stay (LOS).
Q:What benefits does TIEO offer both patients and nurses?
Carver: Although TIEO is a designated independent nursing intervention, it has been underused. However, this is changing as essential oils become increasingly popular with patients and nurses. TIEO intervention is a huge satisfier for nurses who welcome having the autonomy to offer aromatherapy to patients without a physician’s order. They also appreciate the autonomy patients have to self-administer TIEO as soon as they feel discomfort. It also removes the need to consider IVs, dosage requirements, and side effects, all aspects that can stretch nurses thin and lead to errors. Nurses feel empowered to have another tool in their toolbox to help promote patient comfort, and they like that inhaled essential oils are fast, safe, effective, and widely accepted by patients.
Research shows that aromatherapy interventions can significantly improve the patient experience. In fact, in the study noted above, 97% of participants who reported being satisfied with the intervention said they would use inhaled essential oils again. Not only does aromatherapy offer patients relief from their discomfort, but they also say it feels like an act of compassion when they receive it. There are also key cost benefits for hospitals. Research shows that poor patient nausea and vomiting outcomes can affect hospital performance, operational costs, and perceptions of care. According to a study at Queens Medical Center in Honolulu, patients given QueaseEase after experiencing post-operative nausea spent 15 fewer minutes in the PACU, reducing costs.
Q:What key steps should health leaders take when introducing this practice into their hospitals?
Carver: Currently, we're finding that bedside nurses are primarily the ones who are introducing TIEO to their hospitals through shared governance committees or quality improvement projects in their units. This can lead to practice silos and inconsistency with use across hospital departments. Nurse executives who understand the value of TIEO are vital to introducing aromatherapy as an intervention and in adopting a system-wide policy. Sutter Health in Northern California sets an excellent example. They've created a comfort promotion nursing policy to standardize the use of aromatherapy across their facilities in California and Hawaii.
It’s also crucial to establish best practices from the start to ensure patient safety and satisfaction. Most importantly, the delivery system should prevent essential oil from coming in contact with skin or mucous membrane to reduce patient risk. TIEO should be administered in a low ambient concentration and have the ability to close off to avoid widespread diffusion. These steps will also help prolong effectiveness and meet a patient’s needs from admission to discharge.