2.50
Hdl Handle:
http://hdl.handle.net/10755/152134
Type:
Presentation
Title:
Adherence to the preoperative fasting guideline
Abstract:
Adherence to the preoperative fasting guideline
Conference Sponsor:Sigma Theta Tau International
Conference Year:2007
Author:Meents, Nanda, MSc
P.I. Institution Name:Academic Medical Center University of Amsterdam
Title:PhD Student
Co-Authors:Hester Vermeulen, PhD and Dirk T. Ubbink, MD, PhD
[Evidence-based Presentation] Introduction: In 1999 the American Society of Anaesthesiologists recommended to replace the traditional preoperative æfasting from midnightÆ regimen by a more tolerant approach. Their evidence-based guideline permits unrestricted clear fluid intake up to 2h, breast-feeding up to 4h, and a light-breakfast up to 6h before surgery. However, the actual widespread variations in fasting instructions and available literature on actual fasting times reveal inadequate guideline implementation, possibly resulting in patient discomfort and a preoperative hypoglycaemic state in surgical patients. Purpose: We studied the extent of variation in preoperative fasting policies among anaesthesiologists, surgeons and nurses in a university teaching hospital. We also studied possible barriers to comply with the guideline. Both to improve implementation of the guideline. Methods: Questionnaires about professionalsÆ fasting policies were sent to 25 anaesthesiologists, 44 surgeons, and 126 nurses of five different paediatric and surgical wards of a university teaching hospital. Besides, 100 adult patients, 10 children, and 10 parents of hospitalised infants were interviewed about their fasting periods. Results: Adult and paediatric surgical patients were subjected to preoperative fasting times approximately three to four times longer than advised by the guideline. Adult patients reported hunger (13%) and thirst (32%). Contrary to other patients, infants fasted according to the guideline. Only 27.4% of the nurses adhered to the guideline, which was significantly less than anaesthesiologists (57.1%) and surgeons (56.7%). Most patients received instructions on preoperative fasting from a nurse. Guideline implementation barriers were: changes in the operating schedule, operation indications, and lack of research awareness. Nurses prefer receiving information through a form in the nursing dossier, clinical lessons and a pocket card. Conclusion: Current practice still shows prolonged and variable fasting times. Because patients mainly depend on the nursesÆ fasting instructions, nurses should be educated about the negative effects of prolonged fasting in order to improve guideline adherence.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleAdherence to the preoperative fasting guidelineen_GB
dc.identifier.urihttp://hdl.handle.net/10755/152134-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Adherence to the preoperative fasting guideline</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Meents, Nanda, MSc</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Academic Medical Center University of Amsterdam</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">PhD Student</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Nanda.Meents@student.uva.nl</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Hester Vermeulen, PhD and Dirk T. Ubbink, MD, PhD</td></tr><tr><td colspan="2" class="item-abstract">[Evidence-based Presentation] Introduction: In 1999 the American Society of Anaesthesiologists recommended to replace the traditional preoperative &aelig;fasting from midnight&AElig; regimen by a more tolerant approach. Their evidence-based guideline permits unrestricted clear fluid intake up to 2h, breast-feeding up to 4h, and a light-breakfast up to 6h before surgery. However, the actual widespread variations in fasting instructions and available literature on actual fasting times reveal inadequate guideline implementation, possibly resulting in patient discomfort and a preoperative hypoglycaemic state in surgical patients. Purpose: We studied the extent of variation in preoperative fasting policies among anaesthesiologists, surgeons and nurses in a university teaching hospital. We also studied possible barriers to comply with the guideline. Both to improve implementation of the guideline. Methods: Questionnaires about professionals&AElig; fasting policies were sent to 25 anaesthesiologists, 44 surgeons, and 126 nurses of five different paediatric and surgical wards of a university teaching hospital. Besides, 100 adult patients, 10 children, and 10 parents of hospitalised infants were interviewed about their fasting periods. Results: Adult and paediatric surgical patients were subjected to preoperative fasting times approximately three to four times longer than advised by the guideline. Adult patients reported hunger (13%) and thirst (32%). Contrary to other patients, infants fasted according to the guideline. Only 27.4% of the nurses adhered to the guideline, which was significantly less than anaesthesiologists (57.1%) and surgeons (56.7%). Most patients received instructions on preoperative fasting from a nurse. Guideline implementation barriers were: changes in the operating schedule, operation indications, and lack of research awareness. Nurses prefer receiving information through a form in the nursing dossier, clinical lessons and a pocket card. Conclusion: Current practice still shows prolonged and variable fasting times. Because patients mainly depend on the nurses&AElig; fasting instructions, nurses should be educated about the negative effects of prolonged fasting in order to improve guideline adherence.</td></tr></table>en_GB
dc.date.available2011-10-26T11:25:15Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T11:25:15Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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