Quality Improvement Project to Reduce Preoperative Fasting Times Before Elective Procedures
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 1,000
- 试验地点
- 1
- 主要终点
- Preoperative fasting time (clear liquids and solids)
研究概览
简要总结
This single-center quality improvement project evaluates preoperative fasting times before elective procedures requiring anesthesiology care. The project aims to reduce prolonged fasting for clear fluids by implementing a local standard operating procedure (SOP) allowing patients to drink clear liquids until being called to the operating room ("drink until called"), supported by staff education and fasting instruction cards. Fasting times and selected perioperative outcomes will be assessed before and after implementation.
详细描述
Traditionally, surgical patients are instructed to fast for prolonged periods to reduce the risk of pulmonary aspiration. International guidelines recommend fasting from clear liquids for 2 hours prior to elective procedures, yet real-world fasting often extends to 6-10 hours, which can impair patient well-being and may contribute to complications such as dehydration, hypoglycemia, postoperative nausea and vomiting, and delirium-particularly in older or frail patients. This quality improvement project follows the Plan-Do-Study-Act (PDSA) framework.
Plan: Review evidence and decide to implement "drink until called to the OR." Do: Train anesthesiology staff, adapt local SOPs, provide oral patient instructions, and introduce fasting instruction cards for patients and staff.
Study: Record and analyze fasting times and fluid intake prior to anesthesia induction; assess effectiveness and adjust strategies.
Act: Add further staff education, posters, and short instructional screencasts to reinforce the updated fasting guidance.
研究设计
- 研究类型
- Observational
- 观察模型
- Case Control
- 时间视角
- Prospective
入排标准
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •All patients elective surgery or intervention requiring with anesthesiology care general anesthesia, regional anesthesia, sedation, or anesthesiology stand-by
排除标准
- •Already sedated, intubated, and mechanically ventilated patients
结局指标
主要结局
Preoperative fasting time (clear liquids and solids)
时间窗: At anesthesia induction.
Time interval between last intake of clear liquids and anesthesia induction. Time interval between last solid meal and anesthesia induction.
PACU length of stay
时间窗: PACU admission to discharge.
PACU length of stay
次要结局
- Preoperative fasting time (clear liquids and solids)(At anesthesia induction (pre vs post implementation periods).)
- Patient satisfaction regarding fasting(immediately after the intervention/procedure/surgery up to 1 day postoperatively)
- Perioperative complications(Intraoperative and immediate postoperative period (PACU).)
- Postoperative pulmonary and gastrointestinal complications(During the hospital stay up to 30 days)
- Delirium occurrence(During the hospital stay, up to 30 days)
- Hospital length of stay and in-hospital mortality(Until hospital discharge / up to 30 days)
- Acute kidney injury (AKI)(Within the first 3 postoperative days.)
- ICU/IMC admission(During the hospital stay up to 30 days)