Introduction: Fasting is an important safety precaution for patients before surgery but studies indicate that excessive fasting is common. Explanations for this, including patient education related factors, are not well known. The aim of this study was to explore how long patients fast before surgery and what instructions they received, one year after the introduction of new guidelines for patients and professionals.

Material and methods: This descriptive study was undertaken in a national, 660-bed university hospital in 2011. Data was collected from patient records and with questionnaires. Included were adult surgical patients having anaesthesia during a 5day period.

Results: The sample consisted of 193 patients: 83% were scheduled for elective surgery and 86% returned questionnaires. Average fasting time was 13,6 (±3.0) hours for solid food and 8,8 (±4.5) hours for clear fluids. A quarter (27%) had received instructions according to guidelines and 45% were instructed to fast from midnight. Information was either written (18%), verbal (37%) or both (45%) and 46% of patients received information on the importance of fasting. Patients scheduled for morning surgery fasted for a shorter time than afternoon patients (p<0.05). Patients who received both verbal and written information fasted shorter on clear fluids (p<0.001) than others.

Conclusions: The fasting of surgical patients before their operation is unnecessarily long and they do not get uniform instructions. This warrants further exploration. There is a need for staff to coordinate instructional practices, to involve patients more in their own care with consistent information and comprehensive education and assist them in reducing fasting on clear fluids after hospital admission.

Table I. Characteristics of the sample (n = 193).

Table II. Elective surgery: Relationship between fasting and background factors and instructions.

Table III. Fasting and its relationship with type of admission and time of operation.

Figure 1. Excessive food fasting times (> 6 hours) for elective morning and afternoon surgical patients.

Figure 2. Excessive fluid fasting (>2 hours) for elective morning and afternoon surgical patients.

Brynja Ingadottir^1,2, Anna Maria Olafsdottir¹, Herdis Sveinsdottir^1,2, Lara Borg Asmundsdottir¹, Lilja Asgeirsdottir¹, Margret Sjofn Torp¹, Elin J.G. Hafsteinsdottir³

¹Landspitali University Hospital, Surgical services, ²Faculty of Nursing, School of Health Sciences, University of Iceland, ³Landspitali University Hospital Department of Research and Development.