MULTI-CENTRE STUDY OF CURRENT PREOPERATIVE FASTING PRACTICES AMONG ELECTIVE SURGICAL PATIENTS IN FIJI OVER A PERIOD OF 3 MONTHS

Researchers: Naidu K 1
Supervisor: Nasedra L; Mrs Elenoa Seru-Manono 2
Researcher Affiliations:
1 Department of Anesthesia & Intensive Care, CWM Hospital, Suva, Lautoka Hospital, Labasa Hospital, Fiji.
2 Department of Anesthesia, College of Medicine, Nursing and Health Science, Fiji National University, Suva, Fiji.
Key Words: (Preoperative fasting, Fiji, divisional hospitals, healthcare provider knowledge)
Introduction: Preoperative fasting is defined by the American Society of Anesthesiologists as the prescribed period of time before a procedure when patients are not allowed the oral intake of liquids and solids. The guidelines for preoperative fasting have been developed by various Anesthesia societies. However, Fiji does not have standard protocol on preoperative fasting and anecdotally it is common to see patients fasting for longer periods than is actually necessary in the tertiary hospitals. In addition, in this era of evidence based medical practice it is unclear whether the perioperative health care staff in Fiji are knowledgeable about internationally available preoperative fasting guidelines. Therefore, this study aims to evaluate current fasting practices among elective surgical patients at the three divisional hospitals in Fiji. Furthermore, it will investigate the perioperative health care providers’ knowledge on preoperative fasting.
Method: This was a descriptive cross-sectional, multi-center study based at the three divisional hospitals, Lautoka, Labasa and Colonial War Memorial Hospitals, in Fiji between May to July, 2019. The study calculated the mean fasting times from solids and water among 284 elective surgical patients of the three hospitals, and assessed the level of knowledge among 414 perioperative health care providers.
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Results: The mean fasting times were 15.3 hours for food and 13.8 hours for water in Lautoka Hospital; 13.4 hours for food and 13.1 hours for water in Labasa Hospital, and 12.6 hours for food and 12.1 hours for water in CWM Hospital. 241 (84.3%) nurses and 71 (50%) doctors were unaware of ASA fasting guidelines. 173 (66.5%) nurses and 47 (33%) doctors gave incorrect responses for accepted fasting duration for food and
Conclusion: Elective surgical patients in Fiji are over fasted, as a result of lack of clinical guidelines, knowledge deficit among perioperative health care providers, and lack of resources such as information tools for patient education. There is a need for change in practice to an evidence-based approach in order to meet international standards.
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