Development and implementation of a multifaceted strategy to reduce excessive fasting in an acute surgical setting...

Excessive fasting for tests and procedures within the hospital setting remains commonplace, despite clear evidence of the benefits related to reduced fasting. There is minimal research addressing the issue of prolonged preoperative fasting. The aim of this study was to undertake a pre/post implementation study using multifaceted interventions to reduce excessive fasting on acute surgical wards within a quaternary hospital in Sydney, Australia, using the behavior change wheel (BCW) framework.

The BCW was used to identify key strategies to address barriers to implementing evidence-based fasting guidelines. A pre/post implementation study using multifaceted interventions to reduce excessive fasting on acute surgical wards was implemented over a 3-month period. The primary outcome was preoperative fasting time in hours. Clinician interviews were conducted to assess the benefit of each of the interventions within the study.

On completion of preimplementation data collection, strategies were implemented including ward education, guideline promotion, patient stories, patient-facing flyers, and audit and feedback. There was no significant difference between fasting times pre and post intervention. Clinician interviews showed increased awareness and increased confidence.

This pre/post implementation study was unable to significantly reduce fasting times, but did show increased clinician awareness and a trend towards improved patient-reported outcomes. Future research needs to ensure a larger sample size, as well as incorporating emerging strategies such as "sip-to-send" or "think-drink."