Food, Fluid and Nutritional Care Policy update

NHS Tayside’s Food, Fluid and Nutritional Care Policy has been updated with Section 1.2.3: Protocol for Pre-operative Fasting for Elective Surgery/Procedures

All clinical staff and relevant administrative staff must ensure that they have read and understood the policy.

Pre-operative fasting is the time during which a patient is “nil by mouth” before a planned procedure or emergency surgery, and continues until the patient is able to take fluids orally. The policy details the evidence based management of pre-operative fasting (or “nil by mouth”) for all elective surgical procedures, or patients undergoing non-surgical procedures requiring general anaesthesia, or sedation. Prolonged fasting is an inappropriate way to prepare for the stresses of surgery and is detrimental to patients, which results in poor quality care.

The policy also includes:

Standard Operating Procedure: Preparation of the patient for elective surgery/procedures, (Completing the Patient Theatre Ticket)

Appendix 1:  Drugs: Quick Guide – What to stop before surgery
Appendix 2:  Fasting for a Test/Procedure – Quick Reference Guide
Appendix 3:  Guidelines on Preparing In-Patients for Endoscopy
Appendix 4:  Patient Theatre Ticket

Fluid Fasting times

For maximum safety and comfort, patients must be actively encouraged to drink clear fluids until 2 hours before surgery. Recent audits have shown that a significant number of patients are still exceeding fluid fasting times.

Patients may drink unlimited amounts of allowed fluids before coming into hospital. Once in hospital the patient can drink up to 2 hours before surgery. The anaesthetist must determine the time of last drink and note this on the theatre ticket.

Allowed fluids include:

  • Water
  • Clear fruit juice- no pulp/bits
  • Diluting juice
  • Tea of coffee with a small amount of milk

All managers must ensure that their staff read the Policy and the additional sections/sub-sections as they are published, that they understand these, and are implementing the Policy within their area of work as appropriate.

To subscribe and receive updates, please go to Staffnet (see Search link top right corner) and search for ‘Section 1.2.3: Protocol for Pre-operative Fasting for Elective Surgery/Procedures’.  When it appears, under the title link you will see a box ‘Subscribe to this document’ – if you click this you will be notified of any changes/updates.

For further information you can contact the Tayside Nutrition MCN team on 01382 740074, x71423 or e-mail taysidenutrition@nhs.net

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