Adapting an EHR-Based Intervention to Reduce Preprocedural Fasting in Hospitalized Children.
An American Society of Anesthesiologists-aligned electronic health record nothing-by-mouth order was associated with shorter clear liquid fasting in hospitalized children.
Adapting an EHR-Based Intervention to Reduce Preprocedural Fasting in Hospitalized Children.
Prolonged preprocedural fasting in hospitalized children persists despite American Society of Anesthesiologists (American Society of Anesthesiologists) guidelines permitting clear liquids up to 2 hours before anesthesia.
We conducted a quasi-experimental interrupted time series (interrupted time series) analysis from January 1, 2023 through April 23, 2025.
drop in mean clear liquid fasting time after the American Society of Anesthesiologists-aligned order replaced the midnight default
Interrupted time series demonstrated an immediate reduction in fasting duration of 184 minutes (95% CI, -236.9 to -131.2), with no significant postintervention slope change, indicating sustained improvement over 15 months.
Nothing-by-mouth violations and periprocedural emesis did not increase.
A standardized electronic health record-based nothing-by-mouth order was associated with a sustained reduction in fasting duration without increases in measured safety outcomes.
Structural electronic health record modification may represent a scalable strategy to improve alignment with guidelines.