David John
Introduction
Perioperative fasting guidelines across UK trusts show significant variation. While national guidance recommends a two-hour fasting period for clear fluids before day-case procedures, recent international studies support the safety of allowing patients to sip water preoperatively. Prolonged fasting, often due to scheduling delays, result in thirst and discomfort secondary to dehydration with increased rates of postoperative nausea and vomiting. In response, our local trust updated its guidelines to “Sip till Send,” which this project implements.
Methods
A closed-loop audit was conducted using structured, interview-based questionnaires distributed to patients and day-case admission nurses, two months apart. Data collected gauged the adherence of patients and day case admission nurses to the updated principles of pre-operative fasting, including calculation of thirst scores prior to surgery. Interventions between cycles included: placement of posters in day case waiting areas, introduction of a water dispenser, and informal training sessions with nursing and pre-operative teams to improve practice.
Results
Following intervention implementation, there was a 17% increase in patients receiving updated fasting advice, a 31% increase in patients sipping water prior to sending, and a 63% reduction in staff concerns about the practice. Notably, two-thirds of patients reported being offered water while waiting, compared to very few in the initial cycle.
Conclusion
Simple, low-cost interventions successfully improved adherence to the “Sip till Send,” policy, reducing excessive fasting times, increasing patient comfort and equipping nursing staff with the confidence to action the policy, demonstrating the effectiveness of evidence-based policy change in enhancing pre-operative care.
Authors
David John
HHFT, Basingstoke, United Kingdom
Oskar Dytko
HHFT, Basingstoke, United Kingdom