縮短嬰幼兒手術前禁食時間

Shortening Preoperative Fasting Time in Younger Children

臨床發現3歲以下病童接受常規手術，72.2％手術前禁食時間大於8小時；嬰幼兒常因禁食而哭鬧讓父母更顯焦急、無助。本專案的目的在發展一套完整的臨床實務工作指引，以縮短嬰幼兒手術前禁食時間於8小時以內。經文獻查證及小組討論，擬訂以下改善措施：(1)修訂病房手術前禁食標準作業程序；(2)與醫師討論兒童外科手術排程作業；(3)設置醫師手術時段看板。2007年11月1日至11月30日，實地查檢32位3歲以下接受手術病童，結果發現實際禁食時間大於8小時者，由改善前72.2％降至12.5％。本專案實施能改善嬰幼兒術前禁食時間過長的問題，因此期望藉由本專案提供相關照護單位參考，共同提升兒科病童之照護品質。

In the clinical practice setting, over 72.2% of younger children wait for over 8 hours of preoperative fasting. These young children cry easily and are irritable due to their NPO status and therefore increase caregivers’ anxiety. The purpose of this nursing project was to develop practice guidelines to improve preoperative fasting less than 8 hours in children. After a review of literature and group discussions, strategies adopted included (1) revising standard operating procedure of fasting for pediatric patients, (2) designing the pediatric surgeons’ operation of schedule with doctors, and (3) setting up a schedule board of pediatric surgeons’ operation. We have attained the target value by checking 32 children who received surgery during November 1 to November 30, 2007 and found that proportion of preoperative fasting longer than 8 hours reduced from72.2% to 12.5%. The nursing project was effective in shortening preoperative fasting time in children. We expect this project to serve as a reference in clinical practice for promotion of the quality of pediatric care.