Preoperative fasting: knowledge, attitude, and practice of postgraduate trainees at a tertiary care hospital-an observational study

Background: Limiting the preoperative fasting period positively impact surgical patient outcome. In tertiary care hospitals, preoperative fasting instructions are mostly implemented by postgraduates. This study was conducted to evaluate the knowledge, attitude, and practice of postgraduate trainees of surgical specialties and anesthesiology regarding preoperative fasting. This observational study was conducted at a tertiary care hospital in May 2020. Consenting 166 postgraduate trainees of anesthesiology and surgical specialties was asked to respond to a questionnaire consisting of nine questions. The primary outcome was the knowledge status of postgraduate trainees regarding preoperative fasting guidelines and secondary outcomes being their attitude and practice of the same. Categorical data were presented as numbers and percentages. Results: Out of 166 respondents, 149 (89.8%) and 94 (56.6%) respondents could not correctly describe the practice guidelines published by the American Society of Anaesthesiology pertaining to preoperative fasting in adult and pediatric patients respectively. Of the total respondents, 146 (87.9%) and 108 (65.1%) gave incorrect preoperative fasting instructions to adult and pediatric patients, respectively. The source of information regarding fasting guidelines was seniors amongst 89 (53.6%) respondents. Fifty-one (30.7%) respondents were unaware of the benefits of limiting preoperative fasting. Conclusions: There is an imminent need for change in the knowledge, attitude, and practices of residents with regards to preoperative fasting practices. A holistic approach with formal teaching and development of SOP can achieve the change of practice of "NPO after midnight."