Q: Many patients still receive orders for nil per os (NPO) after midnight in the hospital when they are receiving enteral nutrition (EN). What is the best practice for holding feedings before operative or invasive procedures?

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

As discussed in a previous issue of Critical Care Nurse, NPO, or preoperative fasting, 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 the oral intake of liquids or solids.” In the February 2017 article, practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration from the American Society of Anesthesiologists were reviewed as they apply to patients having elective surgery and other procedures performed under anesthesia; these relate mostly to otherwise...

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