Aromatherapy in Healtcare

Aromatherapy in
Healthcare
October 2016
Jody Osteyee, DNP, APRN, CPNP
Aromatherapist
disclosure statement
 The presenter has no relationships with any commercial

entity. Products shown are for education purposes only and
not for personal or professional gain of the presenter.
tell me about you…
objectives
 Identify sources of reputable information about essential oil (EO) use.

 Describe the science of essential oils.
 Discuss the evidence-base for using EOs in healthcare.
 Identify key components of EO use at healthcare facilities.
references and resources
 Books
 Tisserand R & Young R: Essential Oil Safety. A Guide for Health Care Professionals 2nd Ed.,
2014, Churchill Livingston, New York, New York
 Buckle, J: Clinical Aromatherapy: Essential oils in Practice, Third Edition; 2015; Elsevier, St.
Louis, Mo.
 Price S & Price L. (Eds.) (2012) Aromatherapy for Health Professionals 4th ed. Edinburgh:
Churchill Livingstone
 Schnaubelt, K: Advanced Aromatherapy: The Science of Essential Oil Therapy, 1998, Healing
Arts Press, Rochester, Vermont
 Schnaubelt, K: Medical Aromatherapy, Healing with Essential Oils, 1999, Frog, Ltd., Berkeley,
California
 Battaglia, S. (2003). The Complete Guide to Aromatherapy 2nd ed. Brisbane:The International
Centre of Holistic Aromatherapy
 Singh S & E Ernst. (2008) Trick or Treatment? Alternative medicine on Trial. WW Norton & Co.
 People
 Robert Tisserand, Robert Young, Jane Buckle, Jade Shutes, Kurt Schnaubelt
 Associations
 Alliance of International Aromatherapists http://www.alliance-aromatherapists.org/.
 National Association for Holistic Aromatherapy (NAHA) http://www.naha.org/about/mission/
 NIH National Center for Complementary and Integrative Health
http://nccih.nih.gov/health/aromatherapy
 Education resources
 Integrative therapies education http://www.csh.umn.edu/free-online-learning-modules/index.htm
 NAHA approved aromatherapy schools; NAHA website
 American College of Healthcare Sciences, Oregon http://achs.edu/resource/webinars/index.html
 Aromahead Institue, School of Essential Oil Studies, Florida www.aromahead.com
 Journals
 NAHA Aromatherapy Journal
 International Journal of Clinical Aromatherapy http://www.ijca.net/ (Peer reviewed)
 International Journal of Professional Holistic Aromatherapy http://www.ijpha.com/ (Peer reviewed)
 Articles
 Vitale, A (2014) Initiating a Reiki or CAM program in a Healthcare Organization-Developing a Business
Plan. Holist Nurs Pract. 28(6):376-380. This is the November-December issue. Useful info for program
development.
 Soo Lee M, Choi J, Posadzki P & Ernst E. (2012) Aromatherapy for health care: An overview of systematic
Reviews. Maturitas 71; 257-260.
 Campbell L, Pollard A & C Roeton. (2001) The development of clinical practice guidelines for the use of
aromatherapy in a cancer setting. The Australian Journal of Holistic Nursing 8(1):144-22.
 Stea S, Beraudi A & D DePasquale. (2014) Essential Oils for Complementary Treatment of Surgical Patients:
State of the Art. Evidence-Based Complementary and Alternative Medicine. Article ID 726341, pages 1-6.
 Joswiak D, Kinney ME, Johnson JR, Kolste AK, Griffin KH, Rivard RL & JA Dusek. (2016) Development of a
Health System-based Nurse-Delivered Aromatherapy Program. Journal of Nursing Administration 46(4):221-
225.
 Lytle J, Mwatha C & KK Davis. (2014) Effect of Lavender Aromatherapy on Vital Signs and Perceived Quality of
Sleep in the Intermediate Care Unit; A Pilot Study. AJCC 23(1):24-30.
 Lua PL & NS Zakaria. (2012) A Brief Overview of Current Scientific Evidence Involving Aromatherapy Use for
Nausea and Vomiting. The Journal of Alternative and Complementary Medicine 18(6):534-540.
evidence behind EOs
 Blinded randomized control trials are challenging

 Placebo effect
 Evidence-based practice vs. practice-based evidence
 Avoid pseudo-science
 See books by Jane Buckle, and Shirley and Len Price
terminology
 Aromatherapy:
 the use of essential oils derived from plants; aesthetic, clinical, holistic (Buckle);
 inhalation and topical application of true, authentic EOs from aromatic plants to restore
or enhance health, beauty and well-being (AIA)
 also referred to as Essential Oil therapy, can be defined as the art and science of utilizing
naturally extracted aromatic essences from plants to balance, harmonize and promote
the health of body, mind and spirit. It seeks to unify physiological, psychological and
spiritual processes to enhance an individual’s innate healing process.” (NAHA)
 Aromatherapist: one who has completed recognized training in aromatherapy at the
minimum level of 200 educational contact hours approved by AIA, or who has passed a
standardized exam ( Aromatherapy Registration Council)
 Essential oil (EO): substance distilled from aromatic plants( leaf, bark, peel, resin,
etc.). Each oil has a variety of chemical constituents which determine the effect of the
oil.
 Holistic Nursing…
EO science
Kingdom  Example:
Division  Lavendula angustifolia - Lavender

 Boswellia carterii - Frankincense
Subdivision  Rosa damescena – Rose
Class  Melaleuca alternifolia – Tea tree
Subclass  Eucalyptus radiata – Eucalyptus

Eucalyptus dives
Order 
 Eucalyptus globulus
Family  Eucalyptus polybractea
Genus Your EO bottles should be labeled with
botanical names
Species
Also… variety, chemotype, hybrid
chemistry of essential oils
The chemical composition of an oil determines it’s actions
Monoterpene alcohols Sesquiterpene alcohols

low toxicity anti-inflammatory
antibacterial, viral & fungal antiviral
vasoconstrictive
sedative Sandalwood, cedarwood
Peppermint, tea tree
Phenols Ethers
skin irritant neurotoxic
liver toxic psychotropic
nervous system stimulant liver toxic
analgesic
Oregano, thyme
Clove bud, basil
chemistry of essential oils
Ketones Esters
neurotoxic (camphor, thujone) antispasmodic
mucolytic calming
wound healing anti-inflammatory
analgesic antifungal
Frankincense, camphor Lavender, ylang ylang
Aldehydes Oxides
antimicrobial expectorant
anti-inflammatory 1,8-cineole
calming
Rosemary
vasodilator
Lemongrass, lemon
establishing an essential oil program at
your facility…see Joswiak et al, 2016
 Holistic nursing model  Storage
 Program lead  Policies and procedures
 Determining EO  Staff education
application methods  Patient education
 EO supply chain  Documentation
 Safety
 Holistic nursing model: cultural readiness assessment, leadership
support, budget
 Program lead: certified Aromatherapist; track program and outcomes
 Determining EO application methods: inhalation, topical
 Essential oils: determine oils, purchase quality oils, use supply chain?,
expiration, oxidation, track use
 Safety: storage, EO MSDS, infection control, splashes, reactions,
spills, external only, “natural does not mean harmless” (AIA)
 Storage: cool & dark, secured, workflow friendly, pharmacy
 Policies and procedures: independent nursing intervention, FDA
friendly language, curb off-policy use, cautions/contraindications
 Staff education: 1 hour mandatory, refresher info, job aides
 Patient education: FDA friendly language
 Documentation: symptom, assessment, EO, route, frequency,
outcome
essential oils and symptoms
Essential Oil Indications Possible
contraindications
Lavender • Anxiety Active respiratory disease

(L. angustifolia) • Insomnia
• Pain Migraine
Mandarin • Nausea Poorly controlled seizures

(Citrus reticulata) • Restlessness and
anxiety Pregnancy
Peppermint • Nausea
(Mentha x piperita) • Pain
• Urinary retention**
Spearmint • Nausea
(Mentha spicata) • Anxiety
EO uses in healthcare
 Wound care
 Nausea
 Urinary retention
 Alertness
 Settings  Insomnia
 Acute care  Anxiety
 Intensive care  Skin care
 Clinics  Digestion
 Procedure centers  Nasal congestion
 Hospice
 Home health
EO aromasticks/inhalers/patches
https://www.beekley.com/Aromatherapy/Elequil-aromatabs cotton ball in a cup and fabric hearts
Contact for pricing
inexpensive
$.065
http://www.aromahaler.com
EO aromasticks/inhalers/patches
http://aromastick.net
www.wyndmerenaturals.com
4-5 Euros www.Bioessetech.com

$5.50 $2.29
OR….Buy blanks and make your own!
$2.00, blanks available

Topical route
 EO choices; 1-2 EOs

 Carrier oil, massage lotion, emollients
 Pre-mixed vs. nursing preparing: consistency,
nursing workflow; Protocols
 Massage techniques
 Know contraindications
additional uses
 Oral infection: tea tree added to toothpaste or mouthwash
 Wound care: lavender/rosewood/geranium cream
 Hydrosols for burns, abrasions
 Insomnia;(decrease sedative use): lavender, marjoram, geranium, mandarin, cardamom,
rose
 Autistic patients: lavender
 N & V: peppermint, spearmint, ginger
 Pain: black pepper, frankincense, peppermint, lavender, rose, ylang ylang, etc.
 Stress: lavender, bergamot, geranium
 Urinary retention: peppermint drop in toilet
 Nicotine addiction: black pepper
 Hospice: hospice blends (sandalwood, rose, roman chamomile, helichrysum, etc.)
 So many more
program outcomes
 No adverse events
Essential Oil Usage  Add anecdotal information
Primary Children's Hospital 2014
160
140
120
100
"doses"
NTU
80
IMSU
CMU
60
CSU
CTU
40
20
0
Entries lavender Mandarin Peppermint Spearmint Pain Anxiety Nausea Insomnia
comments, questions, complaints!
My contact info:
Jody Osteyee, DNP, APRN, CPNP
(801) 662-2253
[email protected]

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Aromatherapy in

 The presenter has no relationships with any commercial

 Identify sources of reputable information about essential oil (EO) use.

 Blinded randomized control trials are challenging

Division  Lavendula angustifolia - Lavender

Subclass  Eucalyptus radiata – Eucalyptus

Monoterpene alcohols Sesquiterpene alcohols

Peppermint, tea tree

Lavender • Anxiety Active respiratory disease

Mandarin • Nausea Poorly controlled seizures

Contact for pricing

4-5 Euros www.Bioessetech.com

OR….Buy blanks and make your own!

$2.00, blanks available

 EO choices; 1-2 EOs

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