Reducing preoperative fasting time for children: A multidisciplinary quality improvement project
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View abstract on PubMed
Summary
This summary is machine-generated.Excessive preoperative fasting for pediatric inpatients undergoing multiple procedures was reduced by implementing a customizable Electronic Medical Record (EMR) diet order. This quality improvement initiative significantly shortened nil per os (NPO) times, improving patient care.
Area Of Science
- Pediatric Anesthesiology
- Quality Improvement Science
- Healthcare Informatics
Background
- Pediatric inpatients undergoing sequential procedures often face prolonged pre-procedure fasting beyond American Society of Anesthesiology (ASA) guidelines.
- Repetitive fasting periods can negatively impact patient well-being and adherence to care protocols.
Purpose Of The Study
- To decrease excessive preoperative fasting durations in pediatric inpatients requiring multiple procedures within a month.
- To implement and evaluate a quality improvement project at a tertiary care facility.
Main Methods
- A multidisciplinary team identified the "nil per os" (NPO) after midnight Electronic Medical Record (EMR) order as a key factor in prolonged fasting.
- A customizable pre-procedure diet order was implemented, and its impact was monitored using process-control charts over 26 months.
- Plan-do-study-act cycles were employed within the Model for Improvement framework.
Main Results
- The median percentage of patients fasting for over eight hours decreased from 74% to 50% post-implementation (p=0.005).
- Following the identification of special cause variation at 15 months, prolonged fasting affected only 34% of patients.
- Median NPO duration significantly reduced from 12.6 hours to 7.6 hours (p=0.0001).
Conclusions
- Implementing a customizable EMR-based pre-procedure diet order effectively reduced preoperative fasting times for pediatric inpatients.
- Successful implementation hinges on multidisciplinary and interprofessional collaboration, adhering to quality improvement best practices.
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