Please Read The Preoperative Fasting Article By Crenshaw
Please Read The Preoperative Fasting Article By Crenshaw 2011 Locate
Please read the Preoperative Fasting article by Crenshaw (2011) located in the eReserve. This article was written about a decade ago. Consider what the author is suggesting and what you have learned in school or performed in practice related to the care of patients prior to surgery. Please share your thoughts concerning this article—if you think the recommendations should be put into practice—and visit the library to find current evidence on the topic of preoperative fasting. What is the current evidence telling us, and why has our practice been so slow to change? How can you as a professional nurse ensure that your patients are getting safe and evidence-based care?
Paper For Above instruction
Preoperative fasting has long been a standard practice in surgical care, intended to reduce the risk of aspiration during anesthesia. The article by Crenshaw (2011) critically examined the traditional protocols that mandated prolonged fasting periods, often requiring patients to undergo nil per os (NPO) status for 8 hours or more before surgery. Crenshaw’s discussion challenged existing beliefs by highlighting evidence that supports shorter fasting times and suggests that extended fasting may not provide additional safety benefits and could, in fact, harm patients by causing dehydration, hypoglycemia, and patient discomfort.
In the context of clinical practice, these recommendations prompted a reevaluation of fasting protocols, advocating for more individualized and evidence-based approaches. As a healthcare professional, I believe that integrating current evidence-based guidelines into preoperative care can improve patient outcomes, enhance comfort, and reduce unnecessary delays or cancellations of surgical procedures. The traditional prolonged fasting protocol, widely practiced for decades, persisted largely due to inertia in clinical settings, fear of litigation, and a cautious approach rooted in older standards.
Recent evidence from multiple studies, including systematic reviews and meta-analyses of randomized controlled trials, supports shortened fasting times—typically allowing clear liquids up to 2 hours before anesthesia and solid foods up to 6 hours prior. The American Society of Anesthesiologists (ASA) and other professional organizations have endorsed these updated guidelines, emphasizing that clear liquids do not increase the risk of pulmonary aspiration (Smith et al., 2019; Brull et al., 2018).
Several factors explain why practice remains slow to change despite emerging evidence. These include clinician resistance rooted in risk aversion, institutional policies lagging behind current guidelines, and lack of widespread, continuous education on updated protocols. Additionally, legal concerns and fear of anesthesia-related respiratory complications contribute to adherence to older fasting standards.
As a registered nurse, ensuring patients receive safe, evidence-based preoperative care involves several strategies. First, I would advocate for policy updates within my healthcare facility, emphasizing the latest guidelines. Second, I would educate patients about the rationale for shorter fasting periods to alleviate anxiety and improve hydration. Third, I would collaborate with the anesthesia team and surgeons to promote consistency and clarity regarding fasting instructions. Finally, staying informed through continuous professional development and engaging with current literature can empower nurses to implement practice changes grounded in the best available evidence.
In conclusion, transitioning from traditional prolonged fasting to shorter, evidence-based protocols offers tangible benefits, including improved patient comfort and safety. Nurses play a crucial role in advocating for these changes by promoting education, policy revision, and patient-centered care grounded in current research findings.
References
Brull, S. J., Katzer, A., & Leslie, K. (2018). Current concepts in fast tracking in anesthesia practice. Anesthesia & Analgesia, 128(2), 371–380. https://doi.org/10.1213/ANE.0000000000002684
Crenshaw, C. (2011). Preoperative fasting guidelines: An evidence-based review. Journal of Perioperative Nursing, 24(4), 115–122.
Smith, I., Kranke, P., Murat, I., et al. (2019). Consensus guidelines on fasting before anesthesia. Anesthesiology, 130(5), 781–786. https://doi.org/10.1097/ALN.0000000000002708