UHDB is delighted to today (Monday 20 November) launch new fasting guidance for adult patients which will allow them to sip a small cup of water every hour up until the time of their procedure.
We know from feedback from patients that having to go for prolonged periods of time without being able to drink is uncomfortable and causes dehydration. The new guidance, known as Sip Til Send, aims to make patients more comfortable before their procedures, but also provides benefits afterwards, too.
Under the new guidance, all adult patients who require sedation or an anaesthetic will be allowed to sip a small cup of water (up to 170ml) each hour before their procedure - unless stated otherwise by your clinician.
The benefits this brings include decreased potential side effects of sedation an anaesthetic after your procedure, including nausea and headaches, enhanced recovery, and allows for those who are breastfeeding to continue to do so normally.
Sip Til Send was initially adopted at NHS Tayside in Scotland and following successful implementation, more than 30 trusts across the UK have now adopted the guidance, in addition to healthcare organisations in Europe, Asia, Australia, and New Zealand.
The team at Royal Derby Hospital's Hand Day Case Unit have been trialling the new guidance since mid-October, which has been met with positivity from patients who stated that just a small amount of water every hour helped to make a huge difference to how they felt.
One of those patients was 72-year-old retired engineer John Elliott from Wirksworth, Derbyshire, who had a procedure under sedation for a Dupuytren's contracture in his right hand - a condition which causes the ligaments in the hand to stiffen over time, resulting in fingers bending in towards the palm of the hand which often requires surgery to correct.
John's plays a number of instruments, and he said his condition was beginning to prevent him from being able to do so: "I play the guitar and piano a lot, and the Dupuytren's is now impairing my ability to do this quite significantly."
After undergoing the same procedure on his left hand three years ago, John remembers how dehydrated he fault before his procedure, and said being able to have sips of water time this time around has had a positive impact:
"When I came in for my previous procedure, I remember not being able to drink and it was quite uncomfortable, and I was very thirsty. Being able to have just this small amount of water has made a huge difference and I feel much better for it.
"I was a bit unsure about whether I should be drinking, but the team have explained everything to me really clearly and have put me at ease about this and my procedure and are looking after me really well."
Michelle Moran, Senior Theatre Practitioner in Hands Theatres, said it has been great to see the positive impact the new guidance has had for patients - but said that it has also provided further benefits for colleagues, too:
The difference this has made in a short space of time has been amazing. We have received so much positive feedback, with patients saying they feel more comfortable, and we as staff get to have more interactions with them and build rapport as we're around the area ensuring they've got fresh water each hour.
"On Mondays, our patients are asked to attend the department at 7.30am, which sometimes mean they can wait for a while before their procedure. For these patients, being able to have a drink has been a huge positive.
"As patients are better hydrated, it also helps clinically by making cannulation much easier as their veins are hydrated, so it's been a really positive change."
Dr Paul Marval, Consultant Anaesthetist and Clinical Lead for Sip Til Send, said that being allowed to sip water not only has clinical benefits, but also makes a huge difference to the patient experience:
"This is a small but a significant cultural change and simplifies how patients are prepared for their operation, benefitting their experience both before and after their procedures.
"Historically, patients were allowed to drink water up until two hours before procedures for safety reasons. We now recognise that some patients were commonly being fasted for much longer, due to unpredictable timings of going to theatre, causing an unpleasant experience.
"Evidence now suggests that small volumes of water are beneficial to the stomach, while also making patients feel much better and more comfortable and avoids them becoming dehydrated, which all has a huge positive impact on patient experience."
What you need to know about Sip Til Send
- This will become standard guidance for all adult patients undergoing surgery or a procedure requiring an anaesthetic or sedation from Monday 20 November - unless stated otherwise by your clinician
- You may sip up to 170ml of water until you are called to theatre or for your procedure
- Fasting guidance for food and a variety of other drinks remains unchanged and you should not consume these after the time specified in your pre-operative guidance
- Fasting guidance for food and variety of other drinks remains unchanged and patients should not consume these after the time specified to them in the pre-operative guidance
What do I need to do?
Speak to your clinician and our teams about Sip Til Send and what this means to you ahead of your procedure.
Please note: this guidance is for adult patients only and there may be instances where this does not apply to you. Your clinician will discuss with you if you are not to follow Sip Til Send guidance.