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Factors influencing the fasting decisions of day-case surgery patients

18 July 2024
Volume 33 · Issue 14

Abstract

Background:

Patients admitted on the day of surgery are asked to arrive fasted, and they often fast for longer than necessary. Although pre-assessment supports patients to prepare for surgery, little is known about how they make fasting decisions.

Aims:

To explore factors influencing the fasting decisions of day-case patients and how to provide information pre-operatively.

Methods:

A qualitative descriptive study design was used. Semi-structured telephone interviews were carried out with 10 patients recruited from a single day-case unit. Data were analysed using thematic analysis.

Findings:

Three themes provided context for fasting decisions: the operation as a serious event; the patient as an active partner; and the patient as a rule follower. Length of fast is determined by fasting decisions and practicalities.

Conclusion:

Patients approach fasting decisions according to their knowledge and experience and their individual preferences for information. Pre-assessment nurses should tailor information to the patient and explain the rationale for fasting.

The provision of elective surgery has changed in response to increased demand and a reduction in the availability of hospital beds, with patients routinely admitted on the day of surgery (Mayhew et al, 2021). Day-case admission plays a key role in UK health policy and is now the norm for a range of surgical procedures (Bailey et al, 2019). The COVID-19 pandemic severely impacted the delivery of elective procedures and day-case surgery has the potential to help address the resulting backlog (McWhinnie et al, 2021).

However, day-case surgery has resulted in a transfer of the burden of care to patients and their carers (Sokol and Neerukonda, 2013). Individuals admitted for day-case and same-day surgery must ensure they have complied with the required pre-operative instructions and preparations (Gilmartin and Wright, 2008). This includes pre-operative fasting, which is necessary to mitigate the risk of pulmonary aspiration (Rawlinson and Minchom, 2007).

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