PREOPERATIVE FASTING TIME AND FACTORS AFFECTING ADHERENCE TO PREOPERATIVE FASTING TIME AMONG ADULT PATIENT UNDERGOING ELECTIVE SURGERY AT SAINT PAUL’S HOSPITAL MILLENNIUM MEDICAL COLLEGE

Abstract

ABSTRACT Introduction: Preoperative fasting is a time-tested professional practice that is undertaken for physiological and precautionary benefits to the patients globally. Adherence to preoperative fasting guidelines is crucial for ensuring patient safety and minimizing complications during surgical procedures. Objective: This study aimed to assess preoperative fasting times and factors affecting adherence to fasting guidelines among adult patients undergoing elective surgery at St. Paul's Hospital Millennium Medical College. Methods: A cross-sectional study was conducted involving 277 patients who underwent elective surgery at St. Paul hospital Millennium Medical Collage. Stratified sampling technique was used to assign sample for each stratum (type of surgery) and systematic random sampling technique was used to select participants from each stratum. Data on sociodemographic and clinical characteristics, preoperative fasting instructions, knowledge, and actual fasting times were collected using a structured questionnaire. Descriptive statistics and logistic regression analyses were performed to identify factors associated with adherence to fasting guidelines. Statistical significance of P < 0.25 for bivariate regression and P < 0.05 for multivariate regression were considered. Result: The majority of patients fasted considerably longer than recommended, with mean fasting times of 9.76 ± 3.21 hours for clear fluids, 10.84 ± 2.92 hours for semi-solids, and 11.92 ± 2.89 hours for solids. Only 10.9% of patients knew the importance of fasting before surgery, and 92.7% did not receive information about why avoiding food and fluids was necessary. Factors significantly associated with poor adherence to fasting guidelines included being scheduled second or later for surgery (AOR: 5.199, 95% CI: 1.412-19.143) and having no previous history of surgery (AOR: 8.746, 95% CI: 2.462-31.072). Conclusion: Prolonged preoperative fasting times and poor adherence to fasting guidelines were observed among the study participants. Patient education, standardized protocols, and multidisciplinary collaboration are recommended to improve adherence, enhance patient safety, and promote better anesthesia and surgical outcomes. VIII Keywords: Preoperative fasting, adherence, elective surgery, patient education, surgical outcomes