Historically patients have been kept Nil by mouth from midnight as a patient safety requirement however excessive fasting has a negative effect on patient outcomes and experience and recent evidence shows that remaining hydrated and drinking up to two hours prior to surgery can have significant benefits.
In 2014 we sought feedback from our patients about their experiences within theatres, some of the feedback received was indicative of patients being excessively fasted so to having a negative effect on patients outcomes and experiences. In response to this the Think Drink Project Group was formed.
The Project Group is made up of various members of the multidisciplinary team and we meet regularly to discuss innovative ways in which to minimise fasting times for our patients waiting for surgery.
We have developed specific Think Drink guidelines and algorithms for staff to aid decision making within theatres and have improved the communication and cohesion between theatres and the ward and admission areas.
In addition to this we have formulated an approved drinks list, patients can choose from tea or coffee with 1/5th skimmed or semi skimmed milk, dilute squash, water, still energy drinks and drinks part of the enhanced recovery after surgery and these can be given until 2 hours prior to surgery, which adds to improved experience. Changing patients perceptions of fasting has also proved vital in the project, one of the ways in which we have done this is by formulating a Think Drink patient information leaflet which is given to patients at their pre- operative assessment explaining the benefits and encouraging them to remain hydrated up to two hours prior to their surgery.
NUH is one of the largest Trusts in the UK providing services to over 2.5 million residents, employing about 14,500 staff carrying out approximately 43,000 elective and emergency procedures each year. Changing a culture in an organisation this large has proved a huge challenge but we have made huge inroads. We have sought innovative ways in which to engage with staff and embed this Trust wide culture change, this has been done in numerous ways.
Our Project lead carries out regular teaching sessions for all staff, nursing, medical and other allied health professional students. We also hold regular Think Drink Educational Stands in the main entrance of our hospitals to increase patient and staff awareness and change perceptions. A bimonthly newsletter is disseminated to all wards and departments with up to date information and guidelines asking staff to speak up as the patients advocate when Think Drink guidelines are not adhered to. Our Project Lead also visits theatres and wards on a regular basis to increase awareness of the guidelines and discuss any problems which staff may be experiencing and troubleshoots to try and resolve any of the problems.
Feedback from our patients coupled with audit data has proved very positive at NUH we are very proud and passionate about the project and to be significantly improving our patients’ outcomes and experience.
Think Drink Project has been shortlisted for a Nursing Times Award in patient safety improvement; winners will be announced on the 26th October 2016. For more information please contact @NUHThinkDrink or email [email protected]