SP2.1.3A quick solution for poor knowledge of fasting requirements for surgical patients

Aim To investigate and improve doctors’ knowledge of fasting requirements for surgical patients undergoing imaging. Introduction Surgical patients require prompt radiological imaging to confirm diagnoses and rapidly initiate management. Fasting regimes prior to different imaging techniques are confusing and poorly understood but are essential for prime image quality. Poor knowledge of these regimes delays scans and leads to suboptimal patient-care. Methods We created a series of MCQs to determine doctors’ knowledge and confidence of these fasting regimes. Our target recipients were surgical junior doctors who frequently requested imaging (n = 27). Modalities included: x-rays, ultrasounds, CTs, MRCPs, and ERCPS. Afterwards, we distributed posters around key clinical area and delivered a 30-minute teaching session. We provided clear guidance of fasting requirements, essential safe-prescribing points and emphasised the importance of communication with the multi-disciplinary team. A questionnaire was then circulated to re-assess doctors’ understanding. Results The mean pre-intervention MCQ score was only 49%, and only 8% were confident in ordering fasting regimes. After our intervention, the average MCQ mark improved by 37% (+/-11%, 95%CI) and the proportion of doctors, who felt confident, increased to 92%. Improvement in understanding was seen in all modalities, most significantly in ERCPs and contrast CT-APs. Wilcoxon signed rank test showed a statistically significant improvement in MCQ marks after our intervention (p < 0.001). Conclusions Fasting regimes prior to imaging is poorly understood. Teaching sessions and guidance documentation is an effective measure to improve understanding. Key communication with the multi-disciplinary team and awareness of these requirements will improve patient care.