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• W4381327044 abstract "Background: International preoperative fasting guidelines recommend a 2-h fasting period for clear fluids in adults.1 Despite this, fasting periods are often in excess of the recommended time. Evidence shows that pulmonary aspiration and associated morbidity is rare.2 Prolonged fasting times, however, can lead to adverse patient effects such as dehydration, anxiety, postoperative nausea and vomiting, metabolic derangements, and delirium.3 4 In the drive to optimise perioperative care and patient experience, we have implemented a ‘Sip Till Send’ Quality Improvement initiative in a tertiary cardio-thoracic centre. Methods: An adult ‘Sip Till Send’ policy was devised after consultation and agreement within the anaesthetic department. All adult elective patients were allowed to drink water, to a maximum of 150 ml h−1, until given premedication or collected for their procedure. Emergency procedures were excluded. There was no change to fasting times for solids. Ward staff were briefed using virtual educational sessions before roll-out. Baseline data on fasting times were collected before implementation and the first repeat audit data were collected 2 months after policy roll-out. The project was registered with the clinical audit department. Results: Baseline data (n=61) showed a median fluid fasting time of 7.6 h (inter-quartile range 4.2–11.0 h). After the roll-out of ‘Sip Till Send’, a median fasting time for clear fluid was reduced to 1.4 h (inter-quartile range 0.8–2.3 h) (n=59). The distribution of fasting times pre-, and post-intervention is displayed in Figure 13. Patients were asked to score their thirst from 1 (no thirst) to 10 (maximum thirst). Baseline data showed a median score of 7, which was reduced to a median of 5 post-intervention. All patients reported their fasting instructions were clearly communicated to them. Survey data were collected from nursing staff after the educational sessions. Some 93% of nursing staff found the educational sessions useful. No adverse events or concerns were reported by the anaesthetic, surgical, or nursing staff during the audit period. Conclusion: We demonstrated a successful implementation of a ‘Sip till Send’ policy and the resultant reduction in fasting times for clear fluids. This success was underpinned by collaborative, multidimensional team working, ranging from catering staff to all levels of ward and theatre staff. We plan to deliver ongoing education, promote this new policy, and repeat data collection in line with a Plan-Do-Cycle-Act approach to ensure sustained improvements and monitor for adverse events. 1.Smith I, Kranke P, Murat I, et al. Eur J Anaesthesiol 2011; 28: 556–692.Cook T. M, Woodall N, Frerk C. Br J Anaesth 2016; 117: 182–903.Morrison C. E, Ritchie-McLean S, Jha A, Mythen M. Br J Anaesth 2020; 124: 363–664.McCracken GC, Montgomery J. Eur J Anaesthesiol 2018; 35: 337–42" @default.
• W4381327044 created "2023-06-21" @default.
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• W4381327044 date "2023-06-01" @default.
• W4381327044 modified "2023-09-26" @default.
• W4381327044 title "Successful reduction of prolonged fasting times in cardiothoracic surgery" @default.
• W4381327044 doi "https://doi.org/10.1016/j.bjao.2023.100199" @default.
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