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Parents' perception and factors affecting compliance with preoperative fasting instructions in children undergoing
Karan Singla1, Indu Bala1, Divya Jain1
1Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Insights
Most parents (91.5%) did not follow paediatric fasting guidelines for surgery. Written, separate instructions for solids and liquids improve compliance, reducing risks associated with prolonged or inadequate fasting in children.
Area of Science:
- Pediatric Anesthesiology
- Surgical Patient Care
- Health Compliance Studies
Background:
- Preoperative fasting guidelines are crucial for pediatric patients to minimize pulmonary aspiration risk during surgery.
- Compliance with these fasting instructions is often suboptimal in ambulatory surgical settings.
- Understanding factors influencing compliance is key to improving patient safety.
Purpose of the Study:
- To evaluate parental adherence to preoperative fasting instructions in children undergoing day care surgery.
- To identify demographic and instructional factors associated with compliance or non-compliance.
Main Methods:
- A cohort of 1,050 children (1-12 years, ASA I-II) undergoing ambulatory surgery were included.
- Parents completed questionnaires detailing fasting instructions, source, duration, and reasons for deviation.
- Statistical analysis identified factors influencing compliance.
Main Results:
- Only 8.5% of parents fully complied with fasting instructions; 88.4% fasted longer than advised.
- Younger parental age, written instructions, and separate solid/liquid guidelines significantly improved compliance.
- Vomiting (25%) and aspiration (5.2%) were cited reasons for fasting deviations.
Conclusions:
- Improving compliance with pediatric preoperative fasting requires better healthcare provider knowledge and coordination.
- Providing clear, written, separate instructions for solids and liquids enhances parental adherence.
- Optimized fasting protocols are essential to mitigate risks in pediatric day care surgery.
Background And Aims:
Fasting guidelines have been recommended in the paediatric population to minimise the risk of pulmonary aspiration. The present study was planned to assess the compliance with fasting instructions in children undergoing ambulatory surgery and identify the factors affecting it.
Methods:
A total of 1,050 ASA I and II children aged 1-12 years, scheduled for day care surgery were enrolled. Parents of these children were given a questionnaire with specific questions like fasting instructions, source of instructions, actual fasting times and reasons for not following instructions.
Results:
Only 90 (8.5%) parents followed fasting instructions as advised. Of the 960 non-compliant patients, 31 (2.9) inadequately fasted while 929 (88.4%) fasted more than advised. While only 5.2% mentioned aspiration, 25% cited vomiting as the reason for fasting. Younger parents (OR = 0.853, 95% CI-0.796 to 0.915), fasting instructions in writing (OR = 10.808, 95% CI-1.459 to 80.059) and separate instruction for solids and liquids (OR = 6.016, 95% CI- 3.663 to 9.883) were found to affect compliance with fasting instructions.
Conclusion:
To avoid risks of prolonged or inadequate fasting in day care surgical patients, good coordination between the anaesthetist and the surgeon and an updated knowledge about the preoperative fasting instructions among the health-care providers is essential. Separate written fasting instructions for liquids and solids should be given to the parents according to their order in the operating list to ensure better compliance with fasting instructions.
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