Date of Award

Spring 5-22-2021

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice

Department

Nursing

First Advisor

Mary Barger, PhD

Abstract

Preoperative fasting of solids and liquids for 8 hours prior to surgeries requiring anesthesia has been the standard for decades. Guidelines developed in 1999 by the American Society of Anesthesiologists (ASA) allow clear liquids up to 2 hours prior to elective surgery in healthy patients. These guidelines were evaluated and endorsed by the ASA in 2011 and 2017. However, after two decades, this policy is still not standard in many facilities. This evidence-based project aims to change the current fasting policy at a surgery center in Southern California to allow clear liquids up to 2 hours prior to elective procedures on healthy patients in order to decrease the sensation of thirst and increase patient satisfaction. An updated policy allowing clear liquids up to 2 hours pre-procedure for healthy patients undergoing elective surgery was developed and implemented after the collection of baseline data. Prior to implementation, a stakeholder modification was made changing the 2 hours fasting to 4 hours clear liquids fasting pre-procedure. Baseline data consisted of 87 patients and indicated that 54% experienced moderate/severe sensations of thirst on a 4-point quality scale after 8 or more hours of solid and liquid fasting. Post-implementation data consisted of 23 patients who received clear liquid fasting instructions for allowing clear liquids 4 hours pre-procedure. A limited difference, 48% of patients, experiencing moderate thirst was found in the post-implementation data. This is likely due to a stakeholder modification from 2 to 4 hours clear liquid fasting. However, patients were nearly 2.5 times less likely to experience prolonged fasting of 12 hours or more (17% vs 41%). The 4 hours clear liquids fasting instructions appeared more beneficial to patients with surgery times scheduled in the afternoon. Policy should reflect current guidelines and be updated when indicated. Healthy patients undergoing elective surgery should not be subjected to prolonged fasting times.

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