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Preoperative fasting times among emergency orthopedic patients in an acute hospital setting: A best practice implementation project

Sanchez, Kristian BSC in nurs, Grad Dip Ortho Nurs (Team Leader)

doi: 10.1097/01.JBI.0000419758.35080.0c
Evidence in Action: Peer Reviewed Article

Background There is a need to establish how long patients awaiting emergency surgery are currently being fasted for preoperatively, so that strategies can be explored to reduce preoperative fasting times.

Aims This project aims to establish how long emergency patient fast for, and set up a working party to discuss the reasons why emergency patients fast for an excessive amount of time.

Method: Phase 1 Conduct a baseline audit and use the Practical Application of Clinical Evidence Systems (PACES) to measure the percentage compliance against specific audit criteria. Phase 2: Met with stakeholders and utilized the Getting Research into Practice (GRIP) program to assist with identifying barriers and recording strategies that were implemented. Phase 3: A post implementation audit was conducted using the same criteria as phase 1.

Results The majority of patients awaiting emergency theater fasted from midnight and for an excessive amount of time. There was a decrease in the amount of patients fasted from midnight on the follow-up audit, but patients continued to fast for an excessive amount of time. There was an increase in the number of nurses who received education on preoperative fasting on the follow-up audit, however, documented actions to prevent periods of prolonged fasting had low percentage compliance on the baseline audit with a slight improvement on the follow-up audit.

Conclusion This project has confirmed that patients awaiting emergency orthopedic surgery do fast for an excessive amount of time, and that barriers, although easily identified, are difficult to overcome. This project has not achieved all of its aims at this stage, but it has enabled discussion around the topic of preoperative fasting to take place that may lead to change in the future.

Associate Clinical Services Coordinator, Royal Adelaide Hospital, Ward Q3, Orthopedic and trauma Service, Royal Adelaide Hospital, North Terrace, SA, 5000


© 2012 Lippincott Williams & Wilkins, Inc.
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