Traditional Preoperative Fasting And ASA Preoperative Fasting - Research Proposal Example

Traditional Preoperative Fasting And ASA Preoperative Fasting Abstract The essay aims to address a two-fold objective to wit: (1) to create a part of the research proposal; and (2) to provide a blueprint of how the study will be conducted. Research Proposal Topic/Area of Concern The old age practice of fasting patients in the perioperative operative longer than the American Society of Anesthesiologist (ASA) recommendations has been found to put the patient at risk for blanket disorders such as nil-per-oral after midnight and feelings of discomfort. ASA liberalized preoperative fasting guidelines by advocating 2 hours fasting of clear liquids 6 hours fasting of solid foods prior to the induction of general anesthesia(Subrahmanyam & Venugopal, 2010, 374). But lack of implementation of these guidelines in the actual practice has not been observed due to risks of aspiration from shortened fasting times. Studies suggest that there is little or no evidence at all that the volume or pH of gastric contents differed significantly in a patient under ASA fasting or on a longer duration fasting (Subrahmanyam & Venugopal, 2010, 375). The topic or area of concern is whether the traditional preoperative fasting has the difference with the standard ASA preoperative fasting as well as if complications will be maintained at a minimal risk or still cannot be avoided using the traditional preoperative fasting. Research Question Is there a significant difference between patients who are NPO from solids 6 hours and NPO from clear liquids 2 hours before their scheduled surgery time as recommended by the ASA and patients who fast greater than the times recommended by the ASA? Problem The research problem is identifying the difference between traditional preoperative fasting and ASA preoperative fasting in terms of outcome. Hypothesis Patients who are NPO from solids 6 hours and NPO from clear liquids 2 hours before their scheduled surgery time as recommended by the ASA have the same outcomes as those who fast greater than the times recommended by the ASA. Purpose of the Study The purpose of the study is to systematically review the outcome of different preoperative fasting regimens in terms of duration of fasting to perioperative complications and patient’s well-being in different adult populations. In addition, the study also aims to identify if there is a significant difference between shorter-duration fasting and longer-duration fasting in the prevention of the risk for aspiration. The study would intend to benefit the patients as discomforts experienced during fasting such as thirst, hunger, pain, nausea, vomiting, and anxiety(Brady, Kinn & Stuart, 2003, n.p.) will be addressed in the study. Theoretical Framework No appropriate theoretical frameworks were identified. Instead, illustrate the anatomy and physiology of the gastrointestinal system during fasting prior to a preoperative procedure. Discuss complications such as aspiration and how do and when will it possibly occur in most instances (Soreide, Eriksson, Hirlekar, Eriksson, Henneberg, Sandin, & Raeder, 2005, 1041). Literature Review – how extensive, steps, evidence of nursing practice An extensive review of literature is necessary in order to support the hypothesis and justify the findings of the study. Steps necessary are the identification of the key concepts/phrases to search such as "fasting in the preoperative period" and "ASA guidelines in the preoperative period." After the right key search, proper search strategy of related literature will be made in electronic databases, conference proceedings, and reference lists from relevant articles in the preoperative fasting. Literature must include findings during medical practice in the 90’s and year 2000 and up to determine advances made in the practice of perioperative fasting and to analyze the outcome of both traditional and ASA preoperative fasting guidelines. Google Scholar, PubMed, Medline, and Wiley Online Library contain electronic sources with an array of related journals, studies, and literature that can support the study also with evidence-based nursing practice. Sample Characteristics/ Sampling Method A randomized controlled trial or sampling method will be used in the pursuit of the study. This will involve comparisons from patients on traditional preoperative fasting and patients from ASA preoperative fasting guidelines. Samples must include healthy adult patients 18-35 years old and without an increased risk for regurgitation and aspiration during induction of anesthesia. Steps of Data Collection/Types or Levels of Data Quantitative data such as ratio and interval should be used in the study. For example, the ratio of complications and interval between two randomized controlled trials. A self-constructed questionnaire will be made to assess the NPO status of patients for surgical procedures. A sample of the questionnaire will be forwarded to the anesthesiologist of the hospital and medical directors. Questionnaires will be distributed to the randomly selected participants and each will be asked to complete a three-page questionnaire consisting of demographics, current NPO status, and any adverse outcomes experienced. Replies will be tabulated and data will be descriptively summarized via frequency distributions and further interpretations will be made out gathered results. Approval Prior to the Study Initial approval to conduct the study will be requested from the dean of the college. After approval of the topic and questionnaire that the researcher will use in the study, the second approval will be communicated to the medical director and anesthesiologist of the hospital under the study. After all, permissions have been approved, the consent form will be distributed to the sample population for approval. Ethical Concerns During the pursuit of the study, ethical issues concerning the safety of humans will be at risk. The reason why anesthesiologist adheres to traditional NPO policy is to minimize the risk of aspiration which is detrimental to the patient’s safety (Green, Pandit & Schork, 1996, 126). Trials consisting of longer-duration fasting and shorter duration fasting will raise the ethical question, “Is it necessary to put a patient’s life at risk to determine the difference between longer-duration fasting and shorter-duration fasting?” With this in mind, approval and guidance from anesthesiologist are deemed necessary and complete explanation of the study must be communicated to the patient. Methods of Data Analysis Statistical analysis is the method of data analysis that the researcher will use in the study to reject or accept the alternative hypothesis presented. This involves percentage distribution and frequency, mean, standard deviation, chi-square, and the t-square. Results will be interpreted accordingly. Setting of the Study The study will be conducted in the in-patient department of the _________ Hospital located in ____________. Participants in the Study From a nursing standpoint, anesthesiologist, doctors, nurses, and patients must be involved in the study. The collaborative effort of health professionals will ensure the safety of the patient, the researchers to justify the hypothesis and contribute findings to health practice, and the patients to enhance awareness on medical interventions. Resources for the Study As stated earlier, online or electronic resources would help a lot in the study. In addition, personal observations, opinions of the experts such as the anesthesiologist and doctors, and findings from previous researchers will strengthen the study under investigation. References Read More