Demographic Predictors of NPO Violations in Elective Pediatric Surgery

Abstract

Purpose: The parents of pediatric patients are routinely instructed to abstain from food and liquids before elective surgeries. Our objectives were to determine if demographic factors were associated with fasting violations and to identify reasons for noncompliance.

Design: This was a matched case-control pilot study.

Methods: A total of 63 patients who violated fasting guidelines were identified and matched to three controls within the same surgical service. Demographic and clinical variables were evaluated as predictors of noncompliance in a multivariate regression model. Qualitative data were coded into the most commonly identified reasons for non per os (Latin)-nothing by mouth violations.

Findings: Parents of children who did not comply commonly reported that they did not receive or did not understand the fasting guidelines. Noncompliant patients were significantly more likely to experience surgical delays and cancellations. None of the demographic and clinical variables assessed were significantly associated with non per os (Latin)-nothing by mouth violations in this pilot study.

Conclusions: Quality improvement actions may be necessary to ensure that parents receive and understand fasting guidelines for their children. This might include use of teach-back methods, modification of instructional materials, or providing follow-up information after the initial encounter.

Keywords: anesthesia; child behavior; communication; perianesthesia nursing; preoperative period; research.