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Abstract：
Objectives Preoperative fasting plays a pivotal role in adequately preparing patients for anaesthesia and surgical procedures. However, it is imperative to consider not only the medical aspects but also patients\' overall comfort, as this can significantly contribute to improved surgical outcome. The primary objective of this quality improvement project (QIP) is to provide healthcare professionals, including anaesthetists, surgeons, nurses, and stakeholders with information regarding insights required to embrace the concept of preoperative snack prescription as a strategy for enhancing patient-centred care. Methods This QIP was conducted in the vascular surgery department of a district general hospital in Wales, United Kingdom. A prospective analysis was conducted in two cycles, i.e., the pre-intervention group (PrIG) and post-intervention group (PoIG), with preoperative snacks such as biscuits, chips, or cakes, being prescribed to the PoIG. A total of 40 patients who met the inclusion criteria were enrolled in this study, with 20 patients participating in each cycle. The timing of preoperative meals, i.e., the closest preoperative breakfast, lunch, or dinner, preoperative snacks (for the PoIG), anaesthesia commencement, and surgical commencement were collected. Data analysis was performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, New York, United States), in conjunction with Microsoft Excel (Microsoft Corporation, Redmond, Washington, United States). Results In our QIP, the PrIG and PoIG comprised 40% (8 out of 20) and 35% (7 out of 20) female patients, respectively, with mean ages of 74 years (range, 61-86 years) and 61.3 years (range, 36-81 years). Within the PrIG, the mean duration from the preoperative meal to anaesthesia and surgery commencement was 17.8 hours (range, 14.6-22.5 hours) and 18.5 hours (range, 16.0-23.3 hours), respectively. In the PoIG, following the initiation of preoperative snack prescription, the mean time intervals between preoperative snack prescription and anaesthesia and surgery commencement were 10.9 hours (range, 6.5-16.0 hours) and 12.0 hours (range, 7.5-16.5 hours), respectively. Conclusions In summary, our QIP has successfully integrated preoperative snack prescription into the local hospital\'s preoperative care policy, prioritising the balance between patient safety and comfort. Based on our single-centre experience, we observed a significant reduction in the time interval between preoperative fasting and the initiation of anaesthesia, decreasing from 18.3 hours to 10.9 hours post-implementation of preoperative snacks. This QIP holds relevance for healthcare professionals as it underscores the benefits of shorter fasting periods, which contribute to heightened patient satisfaction and comfort.
摘要：
目的术前禁食在患者为麻醉和外科手术做好充分准备中起着关键作用。然而,不仅要考虑医疗方面，还要考虑患者的整体舒适度，因为这可以显著改善手术效果。这个质量改进项目(QIP)的主要目标是提供医疗保健专业人员，包括麻醉师,外科医生,护士,和利益相关者提供有关见解的信息，以接受术前零食处方的概念作为加强以患者为中心的护理的策略。方法在威尔士地区综合医院血管外科进行QIP。联合王国。在两个周期中进行了前瞻性分析，即，干预前干预组(PrIG)和干预后干预组(PoIG)，术前零食，如饼干，薯片,或者蛋糕,被处方给PoIG。本研究共纳入40例符合纳入标准的患者，每个周期有20名患者参加。术前进餐的时间，即，最接近的术前早餐，午餐,或者晚餐,术前零食（用于PoIG），麻醉开始,收集手术开始。数据分析使用IBMSPSSStatisticsforWindows进行，26.0版（2019年发布；IBMCorp.,Armonk,纽约,美国),与微软Excel(微软公司，雷德蒙德,华盛顿,美国)。结果在我们的QIP中，PrIG和PoIG包括40%(20人中有8人)和35%(20人中有7人)的女性患者，分别,平均年龄74岁(范围，61-86年)和61.3年(范围，36-81岁）。在PrIG内,从术前进餐到麻醉和手术开始的平均持续时间为17.8小时(范围，14.6-22.5小时）和18.5小时（范围，16.0-23.3小时),分别。在PoIG中,在术前零食处方开始后，术前零食处方与麻醉和手术开始之间的平均时间间隔为10.9小时（范围，6.5-16.0小时）和12.0小时（范围，7.5-16.5小时),分别。结论总之，我们的QIP已成功将术前零食处方整合到当地医院的术前护理政策中，优先考虑患者安全和舒适之间的平衡。根据我们的单中心经验，我们观察到术前禁食和开始麻醉之间的时间间隔显着减少，从实施术前零食后的18.3小时减少到10.9小时。这种QIP对医疗保健专业人员具有相关性，因为它强调了缩短禁食时间的好处。这有助于提高患者的满意度和舒适度。
