# Electronic preoperative fasting abbreviation protocol: creation, application, and training of the patient care team

## TL;DR

This study shows that using an electronic protocol and training healthcare teams can significantly reduce preoperative fasting times in hospitals.

## Contribution

A novel electronic preoperative fasting protocol integrated with electronic medical records and combined with team training effectively reduces fasting duration.

## Key findings

- Preoperative fasting time was reduced from 11.50 to 8.17 hours in one hospital (p:0.000).
- Fasting time also decreased from 8.77 to 8.07 hours in the second hospital (p:0.025).
- Electronic protocol management and team training were key to achieving these reductions.

## Abstract

The preoperative fasting time does not, in practice, meet current recommendations for preoperative care. The implementation of clinical protocols for shortening preoperative fasting has faced numerous barriers. The present study aims to evaluate whether the creation, application and professional training to use a fasting abbreviation protocol, linked to the electronic medical record, is capable of managing and reducing preoperative fasting time.

The study was conducted in two public hospitals in Goiânia, Goiás, Brazil. The DMAIC project methodology (Problem Definition - Measurement - Analysis - Implementation and Control) was used. Initially, the preoperative fasting time was measured in both institutions and the possible root causes for its prolongation were analyzed. Based on this assessment, a fasting abbreviation protocol was developed, managed through the electronic medical record, and the preoperative fasting time was again measured. In parallel, training was carried out for the multidisciplinary team to apply the protocol.

Preoperative fasting time was high and superior to current recommendations in both hospitals. The causes for this prolongation were identified and treated. There was a reduction in preoperative fasting time in both institutions (11.50 vs 8.17 hours, p:0.000) and (8.77 vs 8.07 hours, p:0.025).

The construction of a protocol, considering the needs of each institution, its management through electronic health records and the use of multiple methodologies for training patient care teams make it possible to reduce the duration of preoperative fasting.