ANSWER
Crenshaw (2011) critically analyzes the “nothing by mouth after midnight” (NPO) recommendation and other conventional preoperative fasting methods. In order to improve comfort without raising the danger of pulmonary aspiration, she supports looser fasting guidelines, arguing that patients can drink clear liquids up to two hours before to surgery.
Current Research on Fasting Before Surgery:
Crenshaw’s suggestions are supported by recent American Society of Anesthesiologists (ASA) guidelines. According to the ASA’s 2023 update, healthy patients can drink clear drinks up to two hours prior to the induction of anesthesia when they are having elective procedures. While upholding safety regulations, this strategy seeks to lessen patient discomfort and dehydration.
Anesthesiology
Obstacles to Changing Practices:
The implementation of new fasting procedures has been slow, even with current standards. This gradual change is caused by a number of factors, including:
Institutional Inertia: Change is difficult since established protocols are so embedded in clinical practice.
Knowledge Gaps: It’s possible that some medical professionals are ignorant of the most recent research or its ramifications.
Perceived dangers: Reluctance to change long-standing practices may stem from worries about possible perceived dangers.
Providing Evidence-Based and Safe Care:
You may encourage safe, evidence-based treatment as a licensed professional nurse by:
Keeping Up to Date: To make sure your understanding of preoperative fasting is current, periodically examine recent studies and recommendations.
Promoting Change: Urge your medical facility to modernize its procedures in accordance with the most recent research, placing a special emphasis on patient safety and comfort.
Educating Patients: Allay patients’ worries and improve adherence by explaining the reasoning behind fasting recommendations.
Collaborating with Colleagues: Effectively implement and oversee improved fasting guidelines by coordinating with the surgical and anesthetic teams.
You may help ensure that patients receive safe care that is in line with the most recent research by actively participating in these practices.
References
QUESTION
Please read the Preoperative Fasting article by Crenshaw (2011) located in the eReserve. This article was written about a decade ago. Consider what the author is suggesting and what you have learned in school or performed in practice related to the care of patients prior to surgery.
Please share your thoughts concerning this article- if you think the recommendations should be put in to practice, and visit the library to find current evidence on the topic of preoperative fasting. What is the current evidence telling us and why has our practice been so slow to change?
How can you as a professional nurse ensure that your patients are getting safe and evidence-based care?