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.
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.