Pre-operative fasting - a patient centered approach

Area of Science:

• Medical Guidelines
• Patient Care
• Surgical Procedures

Background:

• Prolonged pre-operative fasting is linked to patient discomfort and medical issues.
• Current guidelines recommend a minimum of 6 hours for food and 2 hours for clear fluids before anesthesia.

Purpose of the Study:

• To audit Moorfields South Pre-operative Assessment Unit's fasting policy for clarity and adherence to national guidelines.
• To assess the impact of updated fasting instructions on patient hydration and fasting duration.

Main Methods:

• A two-cycle audit using patient questionnaires to assess fasting instructions and hydration.
• Review of the existing fasting instruction policy and patient information leaflet.
• Implementation of staff training, revised patient leaflets, and reminder posters.

Main Results:

• Initial audit showed 70% subjective and 40% clinical dehydration; longest fast was 17 hours.
• Post-intervention, only 25% reported subjective dehydration and 25% showed clinical dehydration.
• The longest fasting period was reduced to 8 hours after implementing updated guidelines and patient education.

Conclusions:

• A patient-centered approach to pre-operative fasting, encouraging clear fluids, improves patient well-being and satisfaction.
• Dispelling the outdated 'nil by mouth for eight hours' policy is crucial.
• Hospitals should adopt updated fasting protocols aligned with national guidelines.