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Fasta á undan skurðaðgerð: Leiðbeiningar til sjúklinga og lengd föstu – framskyggn könnun

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Authors
Brynja Ingadóttir
Anna María Ólafsdóttir
Herdís Sveinsdóttir
Lára Borg Ásmundsdóttir
Lilja Ásgeirsdóttir
Margrét Sjöfn Torp
Elín J G Hafsteinsdóttir
Issue Date
2016-06-02

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Other Titles
Preoperative fasting: Instructions to patients and length of fasting – a prospective, descriptive survey
Citation
Fasta á undan skurðaðgerð: Leiðbeiningar til sjúklinga og lengd föstu – framskyggn könnun 2016, 2016 (06):283 Læknablaðið
Abstract
Inngangur: Fasta sjúklinga er mikilvæg öryggisráðstöfun fyrir skurðað- gerð. Rannsóknir sýna þó að sjúklingar fasta mun lengur en leiðbeiningar kveða á um. Ástæður þess, þar með talinn þáttur sjúklingafræðslu, eru ekki kunnar. Tilgangur þessarar rannsóknar var að kanna hversu lengi sjúklingar fasta fyrir skurðaðgerð og hvaða leiðbeiningar þeir fengu varðandi föstu, þegar eitt ár var liðið frá innleiðingu nýrra leiðbeininga til starfsfólks og sjúklinga. Efniviður og aðferðir: Lýsandi rannsókn var gerð á Landspítala árið 2011. Gögnum var safnað úr sjúkraskrám og með spurningalista. Úrtakið náði yfir alla fullorðna sjúklinga sem gengust undir aðgerð í svæfingu eða slævingu á 5 daga tímabili. Niðurstöður: Þátttökuskilyrði uppfylltu 193 sjúklingar, þar af fóru 161 (83%) í valaðgerð. Útfylltir spurningalistar bárust frá 166 sjúklingum, eða 86% af þeim sem uppfylltu þátttökuskilyrði. Meðallengd föstu á mat var 13,6 (±3,0) klukkustundir og 8,8 (±4,5) klukkustundir á tæra drykki. Lið- lega fjórðungur sjúklinga (27%) fékk ráðleggingar um föstu í samræmi við leiðbeiningar og 45% var ráðlagt að fasta frá miðnætti. Upplýsingar voru veittar ýmist skriflega (18%), munnlega (37%) eða hvort tveggja (45%). Upplýsingar um tilgang föstu fengu 46% sjúklinga. Sjúklingar sem fóru í aðgerð að morgni föstuðu skemur en sjúklingar sem fóru í aðgerð eftir hádegi (p<0,05). Sjúklingar sem fengu bæði skriflegar og munnlegar upplýsingar föstuðu skemur á drykki en aðrir (p<0,001). Ályktanir: Skurðsjúklingar fasta mun lengur en nauðsynlegt er og fá mismunandi upplýsingar frá heilbrigðisstarfsfólki. Þörf er á að kanna frekar ástæðurnar fyrir þessu. Starfsfólk þarf að samræma starfshætti sína, virkja sjúklinga meira í eigin umönnun, veita samræmda og fullnægjandi sjúklingafræðslu og aðstoða sjúklinga við að stytta vökvaföstu eftir komu á sjúkrahúsi
Introduction: Fasting is an important safety precaution for patients before surgery but studies indicate that excessive fasting is common. Explanations for this, including patient education related factors, are not well known. The aim of this study was to explore how long patients fast before surgery and what instructions they received, one year after the introduction of new guidelines for patients and professionals. Material and methods: This descriptive study was undertaken in a national, 660-bed university hospital in 2011. Data was collected from patient records and with questionnaires. Included were adult surgical patients having anaesthesia during a 5day period. Results: The sample consisted of 193 patients: 83% were scheduled for elective surgery and 86% returned questionnaires. Average fasting time was 13,6 (±3.0) hours for solid food and 8,8 (±4.5) hours for clear fluids. A quarter (27%) had received instructions according to guidelines and 45% were instructed to fast from midnight. Information was either written (18%), verbal (37%) or both (45%) and 46% of patients received information on the importance of fasting. Patients scheduled for morning surgery fasted for a shorter time than afternoon patients (p<0.05). Patients who received both verbal and written information fasted shorter on clear fluids (p<0.001) than others. Conclusions: The fasting of surgical patients before their operation is unnecessarily long and they do not get uniform instructions. This warrants further exploration. There is a need for staff to coordinate instructional practices, to involve patients more in their own care with consistent information and comprehensive education and assist them in reducing fasting on clear fluids after hospital admission.
Description
To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.
Additional Links
http://www.laeknabladid.is/tolublod/2016/06/nr/5917
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Archived with thanks to Læknablaðið
ae974a485f413a2113503eed53cd6c53
10.17992/lbl.2016.06.86
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Icelandic Journal Articles (Peer Reviewed)

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