Patient Characteristics Associated with NPO (Nil Per Os) Non-Compliance in the Pediatric Surgical Population.

IF 1.7 Q2 PEDIATRICS
Pediatric health, medicine and therapeutics Pub Date : 2022-06-16 eCollection Date: 2022-01-01 DOI:10.2147/PHMT.S361866
Anuranjan Ghimire, Gregory S Maves, Stephani S Kim, Vidya T Raman, Joseph D Tobias
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引用次数: 0

Abstract

Introduction: Cancellation of surgery or delay on the day of service is a huge burden for the patient, family, and healthcare system. Preventable delays impact efficiency and workflow, which may increase costs due to overtime and idle rooms during peak hours. Non-compliance to nil per os (NPO) guidelines remains one of the most common preventable causes for surgical cancellations. The current study sought to investigate and understand patient factors that may be associated with non-compliance to NPO guidelines.

Methods: After IRB approval, a retrospective review of completed and cancelled pediatric procedures requiring the use of anesthesia over a 5-year period was performed. Emergency procedures and inpatient surgeries were excluded. Data regarding patient demographics and surgical service were extracted from the electronic medical records for comparison. A logistic regression model was used to identify factors associated with cancellations due to NPO non-compliance.

Results: There were 825 cancellations due to NPO non-compliance of 144,049 cases for an incidence of 0.57% over the 5-year period. Patients in the 6-12 year old age range and those who self-identified as non-White or non-English speaking had a higher incidence of cancelling due to NPO non-compliance. Compared to ear, nose, and throat (ENT) procedures, cancellations due to NPO non-compliance were more likely in radiology, dental, and urology procedures.

Discussion: Many factors may impact a family's compliance with NPO guidelines. Patient-related factors included those who self-identified as non-White or non-English speaking. Patients having ENT surgery were less likely to have NPO non-compliance than those having radiologic procedures, dental surgery, or urologic surgery. Future interventions focused on these groups may be most effective in limiting day of surgery cancellations.

儿童外科人群NPO(无/ o)不依从性相关的患者特征。
手术取消或延误对患者、家属和医疗保健系统来说是一个巨大的负担。可预防的延迟会影响效率和工作流程,这可能会由于加班和高峰时段的空闲房间而增加成本。不遵守零风险(NPO)指南仍然是手术取消的最常见的可预防原因之一。目前的研究旨在调查和了解可能与不遵守NPO指南相关的患者因素。方法:经IRB批准后,对5年内需要使用麻醉的已完成和取消的儿科手术进行回顾性审查。不包括急诊和住院手术。从电子病历中提取有关患者人口统计和手术服务的数据进行比较。使用逻辑回归模型来确定因NPO不合规而取消的相关因素。结果:5年期间,144,049例患者中,因NPO不合规而取消825例,发生率为0.57%。6-12岁的患者和那些自我认定为非白人或非英语的患者由于NPO不遵守而取消的发生率更高。与耳鼻喉科(ENT)手术相比,放射科、牙科和泌尿科手术因NPO不合规而取消手术的可能性更大。讨论:许多因素可能影响一个家庭对非营利组织指导方针的遵守。与患者相关的因素包括那些自我认定为非白人或非英语的人。接受耳鼻喉外科手术的患者比接受放射学手术、牙科手术或泌尿外科手术的患者更不容易出现NPO不依从性。未来针对这些群体的干预措施可能对限制手术取消最有效。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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