Transforming pre-operative fasting practice: A nurse-led liberal fluid fasting regimen

Abstract

Introduction: Traditional pre-operative fasting practice often involves extended periods without fluids, and can be a source of discomfort and anxiety for patients. This can lead to negative experiences and potentially contribute to complications. Evidence suggests that these practices may not be necessary to minimise the risk of pulmonary aspiration during surgery. This quality improvement project implemented a nurse-led liberal fluid fasting regimen for pre-operative patients. The aim was to improve patient comfort and wellbeing while maintaining safety.

Process: Utilising the ‘knowledge-to-action’ framework for implementation science, the project implemented a nurse-led liberal fluid fasting regimen. This involved reviewing relevant literature, developing the regimen, educating staff and addressing potential barriers. Monitoring and evaluation included tracking adverse events and collecting surveys. The project ensures sustainability through ongoing staff training and observational audits.

Outcomes: The project demonstrated the safety of the regimen, with no reported cases of pulmonary aspiration or other serious adverse events. Statistically significant outcomes were observed in changes in nurses’ perceptions of patient wellbeing (p < 0.001), reduction in clinical signs and symptoms of dehydration (p < 0.001) and patients’ reports of emotional distress related to waiting times (p < 0.001).

Discussion: The project has not only addressed longstanding challenges in pre-operative fluid fasting practices but has also set a new standard for patient-centred care. It has demonstrated effectiveness in achieving a delicate balance between patient safety and enhanced comfort while fostering a culture of compassionate care provision, placing patient wellbeing at the forefront. This evidence-based approach offers a patient-centred alternative to traditional fasting practices and has the potential to be adopted by other health care facilities seeking to improve patient experience and streamline pre-operative care.