pre-operative fasting sofie chaudhri carol gray victoria fraser
TRANSCRIPT
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Pre-operative FastingSofie Chaudhri
Carol GrayVictoria Fraser
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Outline
•Pre-operative fasting guidelines
•1st audit cycle in RAH and VOL
•Changes to implementation of fasting guidelines
•2nd audit cycle in RAH
•Plans for the future
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GGC Fasting Guidelines
am list pm listSolids
including milky drinks and sweets
Fast from 0230
(6 hours)
Fast from 0730
(6 hours)
Tea / coffee with max 2tsp
milk
Allow until 0430
(4 hours)
Allow until 0930
(4 hours)
Clear fluidsAllow until
0630(2 hours)
Allow until 1130
(2 hours)
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1st Audit Cycle•RAH Jan 2012 n=96
•VOL Nov 2012 n=86
•Interviewed in theatre reception
•Asked about fasting times and what instructions they were given
•Asked about whether they had had IV fluids
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Results
•Mean fasting times for solids were 15 hours 7 minutes (RAH) and 13 hours 4 minutes (VOL)
•Mean fasting times for liquids were 13 hours 54 minutes (RAH) and 12 hours 13 minutes (VOL)
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Results RAH
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Results VOL
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Changes to implementation of
guideline•New guidance for wards
encouraging 300mls water at 6am for all day / morning lists and 11am for afternoon lists
•New leaflet for pre-assessment
•Educating staff about GGC guidelines
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Re-audit RAH Jan 2013
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Results
•Mean fasting time for solids was 14 hours 57 minutes (p=0.713)
•Mean fasting time for liquids was 7 hours and 31 minutes (p<0.001)
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What were patients told?
RAH Cycle 1 RAH Cycle 2
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Further improvements?
•Many conflicting sources of information about fasting for patients - not just pre-assessment and ward nurses
•Still work to do in pre-assessment and wards
•Patients allowed unlimited clear fluids up to 6am as well as encouraging 300mls
•Some patients still choosing not to have the recommended fluids
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Plan for the future•Feedback to wards and pre-
assessment
•Look at other sources of information for patients - appointment letters, reception staff, medical staff on wards
•Encourage free fluids overnight in addition to 300mls in the morning