Preoperative fasting and administration of regular medications in adult patients presenting for elective surgery. Has new evidence changed clinical practice?

2000 ◽  
Vol 17 (4) ◽  
pp. 219-220
Author(s):  
Judith Connolly ◽  
Anthony J. Cunningham
Keyword(s):  
Clinical Practice ◽  
Elective Surgery ◽  
Adult Patients ◽  
Preoperative Fasting ◽  
New Evidence

scholarly journals Preoperative Fasting among Adult Patients for Elective Surgery in a Kenyan Referral Hospital

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
George Njoroge ◽  
Lucy Kivuti-Bitok ◽  
Samuel Kimani
Keyword(s):  
Elective Surgery ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Mirror Reflection ◽  
Preoperative Fasting ◽  
Sectional Study ◽  
National Hospital ◽  
Cross Sectional ◽  
Ethical Approval

Background. Preoperative fasting (POF) is physiologically and precautionary important during anesthesia and surgery. POF from midnight has been practiced despite the recommended shorter practice. Objective. Assessing preoperative fasting among adult patients scheduled for elective surgery at Kenyatta National Hospital (KNH). Methods. A descriptive cross-sectional study involving 65 surgical patients. A questionnaire of mixed questions on demographics, reasons, source of instructions, opinion on instructions, time, premedication practices, outcome, and complains on NPO was used. Analysis was quantitatively done with SPSS v. 22. Ethical approval was obtained from KNH-UoN ERC. Results. Of the respondents 93.8% lacked knowledge on the correct reasons for POF and felt that the instructions were unclear and less important <50%. POF instructions were administered by nurses 80%, anesthetists 15%, and surgeons 5%. Most of respondents (73.8%) fasted > 15 hours. The POF outcomes were rated moderately challenging as follows: prolonged wait for surgery 44.6%, thirst 43.1%, hunger 36.9%, and anxiety 29.2%. Conclusion. Nurses are critical in providing POF instructions and care, and patient knowledge level is a mirror reflection of the quality of interventions. This underscores the need to build capacity for nurses and strengthen the health system to offer individualized preoperative interventions as well as monitoring and clinical auditing of fasting practices.

scholarly journals Updating the Evidence Base for Suctioning Adult Patients: A Systematic Review

2009 ◽  
Vol 16 (3) ◽  
pp. e6-e17 ◽  
Author(s):  
Tom J Overend ◽  
Cathy M Anderson ◽  
Dina Brooks ◽  
Lisa Cicutto ◽  
Michael Keim ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Meta Analysis ◽  
Evidence Base ◽  
Health Care Team ◽  
Adult Patients ◽  
Cochrane Library ◽  
Open Versus ◽  
New Evidence

OBJECTIVES: To update a previous clinical practice guideline on suctioning in adult patients, published in theCanadian Respiratory Journalin 2001.METHODS: A primary search of the MEDLINE (from 1998), CINAHL, EMBASE and The Cochrane Library (all from 1996) databases up to November 2007, was conducted. These dates reflect the search limits reached in the previous clinical practice guideline. A secondary search of the reference lists of retrieved articles was also performed. Two reviewers independently appraised each study before meeting to reach consensus. Study quality was evaluated using the Jadad and PEDro scales. When sufficient data were available, a meta-analysis was conducted using a random effects model. Data are reported as ORs, weighted mean differences and 95% CIs. When no comparisons were possible, qualitative analyses of the data were completed.RESULTS: Eighty-one studies were critically appraised from a pool of 123. A total of 28 randomized controlled trials or randomized crossover studies were accepted for inclusion. Meta-analysis was possible for open versus closed suctioning only. Recommendations from 2001 with respect to hyperoxygenation, hyperinflation, use of a ventilator circuit adaptor and subglottic suctioning were confirmed. New evidence was identified with respect to indications for suctioning, open suction versus closed suction systems, use of medications and infection control.CONCLUSIONS: While new evidence continues to be varied in strength, and is still lacking in some areas of suctioning practice, the evidence base has improved since 2001. Members of the health care team should incorporate this evidence into their practice.

scholarly journals Adjustment of Preoperative Fasting Guidelines for Adult Patients Undergoing Elective Surgery

2015 ◽  
Vol 05 (04) ◽  
pp. 115-118 ◽  
Author(s):  
Eissa Bilehjani ◽  
Solmaz Fakhari ◽  
Samira Yavari ◽  
Jafar Rahimi Panahi ◽  
Mohammadreza Afhami ◽  
...  
Keyword(s):  
Elective Surgery ◽  
Adult Patients ◽  
Preoperative Fasting

An exploration of pre-operative fasting practices in adult patients having elective surgery

2020 ◽  
Vol 29 (7) ◽  
pp. 436-441
Author(s):  
Lovejoy Denkyi
Keyword(s):  
Health Professionals ◽  
Elective Surgery ◽  
International Perspective ◽  
Gastric Volume ◽  
Adult Patients ◽  
Cochrane Central Register ◽  
Preoperative Fasting ◽  
Central Register ◽  
Fasting Time ◽  
New Guidelines

Background: Patients fast routinely before elective surgery in order to reduce gastric volume and acidity. The standard fasting time is ‘nil by mouth’ from midnight before surgery. In recent years, new guidelines have recommended that patients remain nil by mouth from clear fluids for 2 hours and from solids for 6 hours. This literature review explored preoperative fasting practices in adult patients from an international perspective. Methods: A literature search was undertaken of databases, including CINAHL Plus, PubMed, Medline, the Cochrane Central Register of Controlled Trials, Science Direct, Sage Journals and Embase. Results: Anaesthetists were found to possess greater knowledge of reduced preoperative fasting than other health professionals including nurses. Conclusion: Actual fasting time was found to be relatively longer than prescribed fasting times.

WikiRecs primary care: developing rapid recommendations for primary care through effective collaboration between systematic review and guideline teams

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697085
Author(s):  
Trudy Bekkering ◽  
Bert Aertgeerts ◽  
Ton Kuijpers ◽  
Mieke Vermandere ◽  
Jako Burgers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Clinical Practice ◽  
Primary Care Physicians ◽  
Urinary Stones ◽  
Care Practice ◽  
Supporting Evidence ◽  
Supervised Exercise ◽  
Review Team ◽  
New Evidence

BackgroundThe WikiRecs evidence summaries and recommendations for clinical practice are developed using trustworthy methods. The process is triggered by studies that may potentially change practice, aiming at implementing new evidence into practice fast.AimTo share our first experiences developing WikiRecs for primary care and to reflect on the possibilities and pitfalls of this method.MethodIn March 2017, we started developing WikiRecs for primary health care to speed up the process of making potentially practice-changing evidence in clinical practice. Based on a well-structured question a systematic review team summarises the evidence using the GRADE approach. Subsequently, an international panel of primary care physicians, methodological experts and patients formulates recommendations for clinical practice. The patient representatives are involved as full guideline panel members. The final recommendations and supporting evidence are disseminated using various platforms, including MAGICapp and scientific journals.ResultsWe are developing WikiRecs on two topics: alpha-blockers for urinary stones and supervised exercise therapy for intermittent claudication. We did not face major problems but will reflect on issues we had to solve so far. We anticipate having the first WikiRecs for primary care available at the end of 2017.ConclusionThe WikiRecs process is a promising method — that is still evolving — to rapidly synthesise and bring new evidence into primary care practice, while adhering to high quality standards.

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