Q: Different institutions have varied protocols related to nil per os (NPO) status before a patient goes into the operating room. What are the best practices or current guidelines regarding proper length of time and what patients can eat before being given NPO status?

A: Jan Powers, RN, PhD, CCNS, CCRN, CNRN, NE-BC replies:

This question seems to be asked frequently by clinicians. Preoperative fasting, or NPO (nil per os) status, is used as a means to prevent intraoperative pulmonary aspiration. “Preoperative fasting” is defined as a prescribed period of time before a procedure when patients are not allowed oral intake of liquids or solids (nothing by mouth).1 

Preoperative fasting is intended to prevent complications of pulmonary aspiration. Perioperative pulmonary aspiration is defined as aspiration of gastric contents that occurs after induction of anesthesia, during a procedure, or in the period immediately after surgery.1,2...

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