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Evidence Based Practice and Nursing Research

November 2012

Traci Denton, RN, BA, CCRN
Adult Emergency Department
Registered Nurse 4, VPNPP

Type of project: Research/Quality Improvement
Title of project: Nothing by Mouth: Eliminating Needless Deprivation in the Emergency Department
Why you chose this project: When I was accepted into the Evidence-based Nursing Practice Fellowship for 2009-10, I was given the invitation to ask the question "Why?", find an answer and to then do something about it. I had over two decades of experience in witnessing patients being deprived of food and fluid for extended time periods. The justification given was that the potential for aspiration pneumonia acquired during a procedure, if a procedure was necessary, was so great and such a threat to the patient that we had to protect them from this certain consequence. I am ashamed to admit that I repeated that statement numerous times to patients and their families when they asked "Why?" During those previously mentioned two decades of nursing, I had noted that emergent patients who had eaten/drank previous to their injury or illness had no delay in their treatment and were able to have their procedures with a protected airway and no adverse aspiration. In contrast. I did witness the adverse consequences of hunger, thirst, dehydration, interrupted routine medication schedules, poor glucose control and a compromise to acid/base balance in those patients that we were supposedly protecting from aspiration. This became my "Why?" and a review of the literative demonstrated that the question had been given an answer that was evidence-based a decade earlier, but was not being practiced. With the help of many, I was able to get the practice implemented in the Adult Emergency Department. It has increased our patient and staff satisfaction, as well as improved the Standard of Care for our patients.

ASA Guidelines

Future plans: I am working on finalizing a manuscript and plan to submit it for publication soon.

Poster presentations:
1.) Nothing by Mouth: Eliminating Needless Deprivation in the Emergency Department - Emergency Nurses Association Annual Conference; San Diego, CA. August 2012
2.) Eliminating Needless NPO in the Adult Emergency Department. Evidence-Based Practice/Nursing Research Conference; Kennesaw, GA. September 2011
3.) Eliminating Needless NPO in the Adult Emergency Department. Vanderbilt University Medical Center Annual Research Day; Nashville, TN. October 2010

Podium presentations:
1.) Eliminating Needless NPO in the Adult Emergency Department. Vanderbilt University Medical Center Annual Research Day; Nashville, TN. October 2011

If you have any questions about Traci's project please email her at Traci.Denton@Vanderbilt.Edu.

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