SHM Converge Scientific Abstract ePoster Gallery-No More Npo at Midnight: Guidelines to Reduce Pre-Procedure Fasting

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The document describes a quality improvement project aimed at reducing unnecessary pre-procedure fasting, or “NPO at midnight,” for hospitalized patients. The team notes that while this practice is common, it does not improve outcomes and can cause harm, including hypoglycemia, acute kidney injury, and patient dissatisfaction.<br /><br />The purpose of the intervention was to improve adherence to existing fasting guidelines that recommend shorter fasting periods before procedures. To achieve this, the project used two main strategies: an educational campaign displayed as a screen saver and an electronic medical record (EMR) intervention in the form of a new “NPO for Procedures” order set.<br /><br />The study compared a pre-intervention period from January 1, 2023 to March 7, 2023 with a post-intervention period from March 8, 2023 to July 26, 2023. Following implementation, there was a 215% increase in Internal Medicine NPO orders that started at 5 AM or 10 AM, suggesting improved alignment with recommended fasting times and a reduction in overly prolonged fasting.<br /><br />Overall, the project concluded that a targeted order set can successfully prompt clinicians to follow evidence-based fasting guidelines, reduce unnecessary NPO duration, and potentially improve patient safety and satisfaction.

Asset Subtitle

Ian Fagan

Meta Tag

Author List Ian Fagan, Joseph Talledo, Mona Krouss, Rebecca Kogan, Surafel Tsega

Category Innovations

Concept NPO Order

Concept Fasting

Concept Adherence

Concept Clinical Guidelines

Concept Educational Campaign

Distinguished Finalist

Presenter Organization Health + Hospitals/Bellevue

Presenting Author Ian Fagan

Track Quality Improvement

Keywords

quality improvement

NPO at midnight

pre-procedure fasting

hospitalized patients

fasting guidelines

electronic medical record

order set

patient safety

hypoglycemia

clinical workflow

NPO Order

Fasting

Adherence

Clinical Guidelines

Educational Campaign