Minimizing Fasting Requirements to Maximize Patient Satisfaction Prior to a Scheduled Cardiac Catheterization

Abstract

Background: Patients are often kept NPO (nil per os), or “nothing by mouth,” longer than necessary before cardiac catheterization procedures. Local Problem: Patients scheduled for cardiac catheterization procedures receive instructions to begin fasting at midnight on the day of their procedure regardless of their scheduled procedural start time. This directive results in patient dissatisfaction as patients are fasting longer than current guideline recommendation. Methods: The facility updated its order set to align with the American Society of Anesthesiologists (ASA) fasting guidelines for scheduled cardiac catheterizations. To evaluate patient satisfaction, a 6-item survey was administered to 169 individuals undergoing cardiac catheterization. The pre-intervention group (n=116) and postintervention group (n=53) were independent samples. An independent T-test was used to analyze differences in patient satisfaction. Results: A statistically significant difference was observed in both patient satisfaction (p= 0.046) and reported fasting duration (p= 0.0248). The pre-intervention group reported an average fasting burden score of 16.92 and an average fasting time of 12.59 hours, compared to the post-intervention group, which had an average fasting burden score of 15.62 and fasting duration of 11.08 hours. No cases of aspiration were reported with either fasting protocol. Conclusion: The results demonstrate that following ASA guidelines can improve patient satisfaction without increasing the risk of aspiration