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

摘要

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. (C) 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.