2024 Nursing Annual Report

Innovations in Nuring

Fluid Conservation in Anesthesia: Pioneering New Guidelines

The unexpected closure of a North Carolina manufacturing plant resulted in a significant medical grade fluid shortage, prompting healthcare teams to reevaluate resource utilization. For the anesthesia team, this shortage necessitated a revision of NPO guidelines for pediatric surgical patients. NPO guidelines were updated to allow patients to consume breast milk up until three hours and clear fluids up to one hour before their scheduled surgery start time and/or up until arrival to COA. This change was designed to improve hydration status, minimize dependence on IV fluids, and maintain patient comfort without compromising safety. These adaptations also led to the creation of updated anesthesia protocols and inpatient order sets, reflecting a proactive response to mitigate the challenges posed by supply chain disruption. To implement the revised NPO guidelines effectively, the surgical teams acted quickly, holding collaborative meetings to develop a cohesive plan tailored to the

evolving needs of our pediatric patients. Written communication—followed by phone calls detailing the updated guidelines—was promptly distributed to all scheduling offices, ensuring clarity across departments. The new guidelines were formalized into a hospital policy for seamless access and adherence. The Anesthesia PreAdmit Screening team (APASS) revised its outpatient teaching materials to incorporate updated NPO guidelines emphasizing prolonged oral hydration. The implementation of the revised NPO guidelines yielded significant improvements in workflow efficiency and patient care. The new policies and order sets have established a standardized framework that supports consistent care across inpatient and outpatient settings. These efforts not only addressed the immediate challenges but also created a more resilient and unified system, reinforcing a commitment to excellence in pediatric surgical and anesthesia care.