Promoting Patient-Centered Fasting Through E-Mail Reminders

Abstract

Historical fasting practices before 1999 advised that surgical patients should have nothing to eat or drink after midnight to minimize the risk of aspiration. This practice can lead to prolonged fasting from food and liquids, which causes irritability, hunger, excessive thirst, and stress for the child and their caregiver. In addition, an increased inflammatory response and insulin resistance can occur during surgery. Research has demonstrated that fasting from clear liquids for 1–2 hours before surgery does not increase the risk of aspiration in children. A pre- and post-intervention quality improvement project was conducted in a pediatric surgical department in central Florida. From March to August 2022, 346 parents of children scheduled for general surgery were included in the project. Both groups received a reminder phone call the day before surgery with their preoperative instructions. In addition to a phone call, the post-intervention group also received an e-mail summarizing fasting instructions and times. This quality improvement project compared fasting times from food, nonclear liquids, and clear liquids before and after implementing an e-mail message reminder. The mean fasting times for clear and nonclear liquids did not change significantly from the baseline group to the post-intervention group. However, the mean solid fasting times did decrease significantly from 13.8 to 12.9 hours (p < .05) in the post-intervention group. Sending an e-mail reminder the day before surgery significantly reduced the mean fasting times for food. However, additional interventions and parental education may be needed to promote a reduction in fasting from clear and nonclear liquids.