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Reducing Fasting Time Before Anesthesia for Pediatric Bronchoscopy: A Quality Improvement Project.

Qi Wang1, Lamei Liu1, Shujing Gao1

  • 1Department of Pediatric Respiratory and Immunology Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.

Journal of Perianesthesia Nursing : Official Journal of the American Society of Perianesthesia Nurses
|March 22, 2025
PubMed
Summary

A quality improvement project aimed to shorten pediatric bronchoscopy fasting times but did not achieve overall reduction. Factors like culture and parental cooperation complicated guideline implementation in Southwest China.

Keywords:
bronchoscopychild/pediatricsfasting guidelinespolicypreoperative fasting

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Area of Science:

  • Pediatric Anesthesiology
  • Quality Improvement Science
  • Healthcare Management

Background:

  • Fasting guidelines before anesthesia are crucial for patient safety.
  • Optimizing pre-procedural fasting times in pediatric patients undergoing bronchoscopy is an ongoing challenge.
  • Implementing standardized fasting protocols requires understanding local contexts.

Purpose of the Study:

  • To reduce fasting time before anesthesia for pediatric bronchoscopy.
  • To implement and evaluate a quality improvement project focused on pre-procedural fasting.
  • To identify barriers and facilitators to guideline localization in Southwest China.

Main Methods:

  • A quality improvement project utilizing the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework.
  • Employed Specific, Measurable, Achievable, Relevant, Time-bound (SMART) objectives and the Plan-Do-Check-Act (PDCA) cycle.
  • Conducted barrier analysis and used control charts and statistical process control for data analysis.

Main Results:

  • The project involved 830 children; the new fasting policy did not significantly reduce overall preoperative fasting time.
  • Fasting time for fluid diets (breastfed, formula) decreased (P=.019).
  • Fasting duration correlated with surgery volume, patient weight, and general anesthesia use.

Conclusions:

  • Reducing pre-procedural fasting times for pediatric bronchoscopy is complex due to cultural, educational, resource, and operational factors.
  • Localization of fasting guidelines in Southwest China faced significant implementation challenges.
  • Further targeted interventions are needed to address influencing factors and optimize fasting policies for improved patient and family experiences.