On a busy Surgical Trauma unit, scheduled procedures and operations are often delayed for priority emergent cases. Patients admitted to the unit with delayed procedures often endure extended fasting times beyond the six-hour intention of standard nothing by mouth (NPO) after midnight fasting order. With prolonged fasting times, patients inquire about pending surgery times and dietary options. Some providers may allow ice chips, but most doctors prefer patients to remain NPO in case Operating Room availability opens for surgery, leaving already anxious and uncomfortable patients more frustrated as prolonged fasting affects patients’ physical and psychological well-being (Anderson & Comrie, 2009). Patient complaints reveal an opportunity to improve patient perceptions of hunger, thirst, comfort, and satisfaction. With the goal to increase patient satisfaction, the following PICOT was examined: In preoperative adults and children (P), how does allowing clear fluids pre-operatively (I) compared to remaining NPO (C) affect aspiration risk (O) during surgery (T)?
Research reveals strong evidence that supports shortened fasting times prior to procedures. Current evidence allows clear fluids up to two hours prior to surgery for healthy children and adult patients that are not at high risk for aspiration undergoing anesthesia (American Society of Anesthesiologists Committee [ASAC], 2011). However, adoption of updated fasting guidelines has been slow to be ingrained into organizational culture with most prescribers ordering the standard NPO after midnight diet in both inpatient and outpatient settings. Because of slow change in clinical practice, it is important to disseminate findings that increase compliance with evidence-based practice and increase patient satisfaction.
Date of publication
MSN Capstone Project
Gasparek, Sheila, "Decreasing Pre-Procedural Fasting Times: A Benchmark Study" (2021). MSN Capstone Projects. Paper 152.