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

    Research output: Contribution to journalArticle

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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

    Fingerprint

    Orthopedics
    Fasting
    Cohort Studies
    Prospective Studies
    Wounds and Injuries
    Operative Time
    Ambulatory Surgical Procedures
    Fast Foods
    Outcome Assessment (Health Care)
    Trauma Centers
    Hip Fractures
    Confidence Intervals

    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

    Cite this

    @article{3254658e0a3446209298f71d180a1a47,
    title = "A prospective cohort study investigating the use of a surgical planning tool to improve patient fasting times in orthopaedic trauma",
    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.",
    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",
    author = "Samantha Downie and Judith Joss and Sankar Sripada",
    note = "Copyright {\circledC} 2018 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.",
    year = "2019",
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    doi = "10.1016/j.surge.2018.05.003",
    language = "English",
    volume = "17",
    pages = "80--87",
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    A prospective cohort study investigating the use of a surgical planning tool to improve patient fasting times in orthopaedic trauma. / Downie, Samantha (Lead / Corresponding author); Joss, Judith; Sripada, Sankar.

    In: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland, Vol. 17, No. 2, 04.2019, p. 80-87.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - A prospective cohort study investigating the use of a surgical planning tool to improve patient fasting times in orthopaedic trauma

    AU - Downie, Samantha

    AU - Joss, Judith

    AU - Sripada, Sankar

    N1 - Copyright © 2018 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

    PY - 2019/4

    Y1 - 2019/4

    N2 - 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.

    AB - 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.

    KW - Fasting

    KW - Orthopedics

    KW - Surgical planning

    KW - Trauma

    KW - Prospective Studies

    KW - Humans

    KW - Middle Aged

    KW - Child, Preschool

    KW - Trauma Centers

    KW - Workload

    KW - Operative Time

    KW - Young Adult

    KW - Time Factors

    KW - Orthopedic Procedures

    KW - Aged, 80 and over

    KW - Preoperative Care/methods

    KW - Adult

    KW - Aged

    KW - Child

    KW - Efficiency, Organizational

    KW - Fractures, Bone/surgery

    U2 - 10.1016/j.surge.2018.05.003

    DO - 10.1016/j.surge.2018.05.003

    M3 - Article

    VL - 17

    SP - 80

    EP - 87

    JO - Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

    JF - Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland

    SN - 1479-666X

    IS - 2

    ER -