Here at Nottingham University Hospitals NHS Trust (NUH) pre-operative services, we work closely with patients and their families to prepare them for elective surgery.

We work cross site at both Queens Medical Centre and City campus.

Our role is crucial in setting the patient off on their surgical journey and we want to make this journey as comfortable and safe as possible.  One of the ways we do this is by endorsing the Think Drink project.  We are particularly passionate about this as it is unpleasant and unnecessary for patients to be starved or be thirsty for long periods before surgery.  By promoting this project and educating patients around fasting we can be confident that patient outcomes post-surgery are improved. Recent research has shown that thirst is one of the commonest causes of severe discomfort outcomes in the perioperative period. [1]

We want patients to recover as safely and quickly as possible and appropriate fasting times are essential to this. If patients are well hydrated then this facilitates normal digestion, good kidney function, optimum wound healing and patient comfort.

Our guidance given at pre-op is individual to the patient, dependent on their surgery and whether they are booked for a morning or afternoon slot in theatre.  Some of our patients are on enhanced recovery pathways and in these instances special pre-operative drinks are given. 

The Nurses at Pre op will reiterate the importance of these instructions to the patients and their families in the clinic environment and provide literature to them to support and remind them when they return home. We know that there is along tradition of 'nil-by-mouth from midnight' - and our team works very hard to help patients and their families understand why shorter fasting times are not only necessary, but also probably safer.

We work closely with consultant anaesthetists to ensure patient safety and Dr Levy is a great advocate for the work which is done within the service.....

“The pre-operative meeting offers the opportunity for a one-to-one meeting with a nurse who can explore the patient’s holistic needs.

It’s the ideal opportunity to explain and reinforce the pre-operative fluid regimen.”

References

1 Walker EMK et al. Patient reported outcome of adult perioperative anaesthesia in the United Kingdom: across-sectional observational study. BJA 2016;117:758-766 https://academic.oup.com/bja/article/117/6/758/2671124/Patient-reported-outcome-of-adult-perioperative

Questions to consider:

What value do nurses add to the Pre op process?

What do patients feedback regarding the service?

How can nurses influence appropriate fasting times?

What are barriers to an effective Pre op service? 

How does effective Pre op benefit our patients?