Key result
An educational and coordination intervention for hospital staff reduced mean preoperative fasting times in children from 11.25 to 9 hours for solids and from 9.25 to 4 hours for water.
Why the study?
Does education of ward nurses and better coordination reduce preoperative fasting time in children undergoing elective surgeries?
Cross-Sectional (n=100)
No
Does education of ward nurses and better coordination reduce preoperative fasting time in children undergoing elective surgeries?
Absolute Event Rate: 4% vs 9.25%
Education of ward nurses and improved coordination among healthcare providers can significantly reduce unnecessary preoperative fasting times in children.
This is the authors' abstract. We don't add key points for this paper.
BACKGROUND: Prolonged preoperative fasting in children is a common problem, especially in highvolume centers. All international professional society guidelines for preoperative fasting recommend 2 h for clear fluids, 4 h for breast milk and 6 h for solids, nonhuman and formula milk in children. These guidelines are rarely adhered to in practice. AIMS: An audit was undertaken to determine the length of preoperative fasting time in children and its causes. SETTINGS AND DESIGN: Cross-sectional study of 50 children below 15 years posted for elective surgeries. MATERIALS AND METHODS: An initial audit was performed at our institution on preoperative fasting time in 50 children below 15 years of age for elective surgeries. The mean preoperative fasting times were found to be much longer than the recommended times. Ward nurses were then educated about internationally recommended preoperative fasting guidelines in children. Anesthesiologists started coordinating with surgeons and ward nurses to prescribe water for children waiting for more than 2 h based on changes in surgery schedule by instructing ward nurses through telephone on the day of surgery. A reaudit was done 6 months after the initial audit. STATISTICAL ANALYSIS USED: SPSS 16 software. RESULTS: The initial audit revealed a mean preoperative fasting time of 11.25 h and 9.25 h for solids and water, respectively. Incorrect orders by ward nurses (74%) and change in the surgical schedule (32%) were important causes. After changing the preoperative system, mean preoperative fasting times in children decreased to 9 h and 4 h for solids and water, respectively in reaudit. Change in surgical schedule (30%) was the major cause for prolonged preoperative fasting in reaudit. CONCLUSIONS: Simple steps such as education of ward nurses and better coordination among the anesthesiologists, surgeons and nurses can greatly reduce unnecessary preoperative starvation in children.
Supports staff education to shorten pediatric fasting; hypothesis-generating and requires randomized trials before practice change.
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Arun et al. (2013) conducted a cross-sectional in Elective surgery (n=100). Staff education and multidisciplinary coordination on fasting guidelines vs. Standard care (initial audit) was evaluated on Mean preoperative fasting time for water (hours). An educational and coordination intervention for hospital staff reduced mean preoperative fasting times in children from 11.25 to 9 hours for solids and from 9.25 to 4 hours for water.
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