Perioperative Fasting and the Patient Experience
Telliane Chon1, Alfred Ma1, Connie Mun-Price1
1Anesthesiology, Riverside University Health System, Moreno Valley, California, United States.
Cureus
|June 28, 2017
Summary
Patients often experience prolonged fasting before surgery due to scheduling delays, exceeding recommended guidelines. This study highlights extended nulla per os (NPO) times, emphasizing the need for improved hospital strategies and education.
Area of Science:
- Anesthesiology
- Surgical Patient Care
- Hospital Management
Background:
- Standard surgical preparation involves overnight fasting (nulla per os, NPO).
- Unpredictable operating room schedules and delays can lead to significantly prolonged patient fasting.
- Recent guidelines suggest shorter fasting periods, allowing clear liquids up to two hours before surgery.
Purpose of the Study:
- To examine the duration of NPO times in elective surgeries.
- To identify the causes of prolonged fasting in surgical patients.
- To assess the need for changes in institutional practices and education.
Main Methods:
- Random sampling of elective surgeries at a Southern California teaching hospital in October 2016.
- Analysis of surgical scheduling data to determine NPO duration and reasons for delays.
- Review of patient fasting times in relation to scheduled operation times.
Main Results:
- Significantly prolonged NPO times were observed in the sampled surgeries.
- The primary cause of prolonged fasting was delays due to previous surgeries running over schedule.
- These delays extended patient fasting beyond recommended durations.
Conclusions:
- Prolonged preoperative fasting is a significant issue caused by surgical scheduling inefficiencies.
- There is a clear need for revised institutional management strategies to optimize patient fasting protocols.
- Clinical education curricula require updates to address prolonged NPO times and patient safety.
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