Document Type

DNP Project

Publication Date


Faculty Advisor

Dorothea Esposito, DNP, MSN/ed, APRN, FNP-BC

Practice Mentor

Valarie Lamarre, MSN, RN


Significance and Background:

Longer preprocedural fasting times in the pediatric population causes distress among children and their families and potentiates postoperative complications. Allowing children to consume clear liquids up to two hours prior to surgery improves satisfaction and decreases overall fasting durations. Current guidelines from the American Society of Anesthesiologists (ASA) allow preoperative consumption of clear liquids up to two hours prior to arrival time. However, preoperative nursing staff at an ambulatory surgery center in Northern, CT are educating patients parents and guardians to keep their children from having “nothing to eat or drink after midnight”.

Purpose: Develop a standardized clear liquid fasting protocol in the surgery center to shorten the preoperative fasting duration of pediatric patients and increase patient and family satisfaction.

Methods: Plan-Do-Study-Act. Plan: A standardized policy was developed at the surgery center to utilize when providing preoperative education. An educational session was developed to provide nursing staff. Do: An informational session was provided to key stakeholders. Study: Data was collected on impact of preoperative fasting instructions in relation to fasting durations and patient and family satisfaction. Act: Presentation of data to key stakeholders.

Outcome: Over the implementation period between September 2023 and December 2023, there were a total of 205 surveys completed (83%). Post-implementation patient satisfaction surveys display 67% of patients followed new fasting guidelines and 33% followed previous guidelines instructing nothing by mouth (NPO) after midnight. Of the patients that consumed clear liquids 2 hours prior to arrival, 61% of parents/guardians strongly agreed that the patient was more cooperative preoperatively.

Discussion: The implementation of preoperative fasting instructions by nursing staff increased patient cooperation and family satisfaction while reducing preoperative fasting durations.


A DNP project submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice, Sacred Heart University Davis & Henley College of Nursing.

Creative Commons License

Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial-Share Alike 4.0 International License.

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