A prospective cohort study investigating the use of a surgical planning tool to improve patient fasting times in orthopaedic trauma

Samantha Downie (Lead / Corresponding author), Judith Joss, Sankar Sripada

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    Abstract

    Objectives: To improve surgical planning and reduce fasting times with a tool designed to predict average surgical times for the commonest orthopaedic trauma operations.

    Methods: A prospective cohort study comprising two 2-week periods before and after introduction of a surgical planning tool. The tool was used in the post-intervention group to predict surgical times for each patient and the predicted end-time for each list. The study was conducted in a UK trauma unit with consecutive orthopaedic trauma patients listed for surgery with no exclusions.

    Intervention: A surgical planning tool was generated by analysing 5146 electronic records for trauma procedure times. Average surgical times for the commonest 20 procedures were generated with 95% confidence intervals. The primary outcome measure was number of patients fasted for a single day. The secondary outcome measures were the day of surgery and total fast times for food and fluids.

    Results: After introduction of the planning tool, patients were more likely to fast for only one day (65% 46/71 vs 53% 40/75, p < 0.05). Day of surgery food fast was significantly lower with use of the surgical planning tool (13:11 h to 11:44 h, p < 0.05). Fast times were lower for patients with hip fractures after the intervention, with a reduction in day of surgery fast from 8:25 h to 4:28 h (p < 0.05) and a total fluid fast of 13:00 h to 4:31 h (p < 0.001).

    Conclusions: Introduction of a surgical planning tool was associated with a decrease in fasting times for orthopaedic trauma patients with no patient cancelled for not being adequately fasted.

    Original languageEnglish
    Pages (from-to)80-87
    Number of pages8
    JournalSurgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
    Volume17
    Issue number2
    Early online date18 Jun 2018
    DOIs
    Publication statusPublished - Apr 2019

    Keywords

    • Fasting
    • Orthopedics
    • Surgical planning
    • Trauma
    • Prospective Studies
    • Humans
    • Middle Aged
    • Child, Preschool
    • Trauma Centers
    • Workload
    • Operative Time
    • Young Adult
    • Time Factors
    • Orthopedic Procedures
    • Aged, 80 and over
    • Preoperative Care/methods
    • Adult
    • Aged
    • Child
    • Efficiency, Organizational
    • Fractures, Bone/surgery

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