Implementing Shortened Fasting Protocols Before Cardiac Catheterization: A Quality Improvement Initiative

Area of Science:

• Cardiology
• Quality Improvement Science
• Patient Safety

Background:

• Routine practice mandates prolonged fasting (NPO after midnight) before cardiac catheterization.
• Emerging evidence suggests shorter fasting durations improve patient experience without increased risk.
• A high-volume cardiac center sought to update its long-standing fasting protocols.

Purpose of the Study:

• To assess the feasibility of implementing a shortened fasting protocol (2 hours) before cardiac catheterization.
• To achieve >70% adherence to the new fasting protocol.
• To evaluate the impact on patient experience and safety.

Main Methods:

• A quality improvement initiative utilized sequential Plan-Do-Study-Act (PDSA) cycles.
• Protocols were modified to allow light meals 2 hours and clear fluids until the procedure.
• Patient experience surveys and safety event monitoring were conducted.

Main Results:

• Adherence targets were met, exceeding 70% in all implementation phases (77%-82%).
• Patients reported reduced hunger and nausea with the shortened fasting protocol.
• High patient satisfaction was maintained, with no observed safety events like aspiration.

Conclusions:

• Shortening pre-cardiac catheterization fasting to 2 hours is feasible in high-volume centers.
• The implemented protocol improved patient comfort and was successfully adopted.
• This initiative demonstrates effective practice pattern change in cardiac care.