Pre-op fasting audit: RAH and VOL Victoria Fraser

Outline Fasting guidelines RAH audit VOL audit 2012 What action have we taken?

GGC Fasting guidelines am listpm list Solids including milky drinks and sweets Fast from 0230 (6 hours) Fast from 0730 (6 hours) Tea/coffee with max 2tsp milk Allow until 0430 (4 hours) Allow until 0930 (4 hours) Clear fluids Allow until 0630 (2 hours) Allow until 1130 (2 hours) Chewing gum is acceptable up to 2 hours pre-op but must not be swallowed Consider commencing IV fluids on any patient who is fasted for a prolonged period (greater than 12 hours)

RAH audit patients interviewed in theatre reception Mean fasting time for solids was 15 hours 7 minutes Mean fasting time for liquids was 13 hours 54 minutes 95% of patients did not have IV fluids

RAH audit

VOL audit patients interviewed Mean fasting time for solids was 13 hours 4 minutes Mean fasting time for liquids was 12 hours 13 minutes 77% had IV fluids

VOL audit 2012

Differences between patient populations RAH and VOL VOL predominantly orthopaedics, RAH more a mix of specialties

What instructions did patients remember? RAHVOL

Conclusions Our instructions to ‘fast from midnight’ result in unnecessarily prolonged fasting times which may be detrimental to patients

What action have we taken? Educating staff about GGC guidelines New guidance for ward encouraging 300mls water at 0600 for am list and 1100 for pm list Alteration to preassessment instructions and new patient information leaflet In the process of re-auditing at RAH

Questions?