AB206. SOH25_AB_332. Preoperative fasting practices at Tallaght University Hospital: a clinical audit and comparison over 5 years

Background: Preoperative fasting is a standard practice prior to elective surgery to mitigate the risk of aspiration. However, excessive fasting can lead to adverse patient outcomes. The objective of this re-audit was to determine whether improved targeting methods of patient education regarding preoperative fasting, including the promotion of a fasting information leaflet and discussions during pre-assessment meetings, resulted in better adherence to hospital fasting guidelines (2 hours for clear fluids, 6 hours for solids) for elective surgical patients at Tallaght University Hospital.

Methods: Data were collected over a 2-week across two hospital locations (N=70) by three auditors. Fasting durations are expressed as medians with interquartile ranges (IQRs).

Results: Median fasting durations were 14.24 hours (IQR, 13.13–15.22 hours) for solids and 7.53 hours (IQR, 4.3–12.38 hours) for fluids, consistent with the 2019 audit. The proportion of patients receiving fasting information leaflets increased from 43% in 2019 to 60% in 2024, and the proportion encouraged to drink clear fluids increased from 30% to 67%.

Conclusions: This audit highlights that despite significant improvements in patient education initiatives, such as the distribution of information leaflets and preoperative discussions, these measures did not translate into reduced fasting times, which remain significantly longer than recommended guidelines. Non-adherence stemmed from unclear instructions and concerns about surgical delays. In line with enhanced recovery after surgery (ERAS) principles, further efforts, including targeted education addressing these concerns and introducing preoperative carbohydrate-rich drinks, could be considered to further address this issue and enhance patient outcomes.

Keywords: Audit; elective surgery; enhanced recovery after surgery (ERAS); patient education; preoperative fasting