Resident Physician Connecticut Children's Medical Center Hartford, Connecticut, United States
Background: Patients are required to fast prior to sedation to decrease the risk of aspiration during procedures. Unlike adults, there is variability in the recommended pre-sedation fasting (NPO) times for pediatric patients depending on type of diet. While current guidelines support minimal recommended fasting times for low risk patients with elective procedures, patients continue to be made NPO at midnight, prolonging NPO times. This practice is especially relevant to pediatric patients as prolonged fasting is linked to patient discomfort, hypoglycemia, decreased caloric intake (needed for wound healing) and necessity for intravenous fluids (IVF). Objective: To improve ordering provider compliance with pre-sedation NPO guidelines through passive clinical decision support within the hospital electronic health record (EHR). Design/Methods: We seek to evaluate the adherence to Connecticut Children’s pre-sedation guidelines after the introduction of clinical decision support within computerized physician order entry in the Electronic Health Record (EHR), specifically a non-interruptive reference to pre-sedation NPO guidelines. A total of 485 patient charts were collected (313 pre, 172 post) from patients admitted to the inpatient service between 1/23- 5/24, who underwent non-emergent sedated procedures. Data collected from pre and post intervention included (1) hours NPO, (2) hours on intravenous fluids, and (3) service and department. We plan to use univariate analyses to evaluate NPO time and time on intravenous fluids, Mann Whitney u tests will be used for continuous variables and chi squared for categorical variables. We expect all data analysis to be completed by January 2025. The project was reviewed by the IRB and did not meet criteria, therefore received IRB exemption.
