Assessment of adherence to pre-operative fasting guidelines and associated factors among elective pediatric surgical patients in Jimma University Comprehensive Specialized Hospital (JUCSH), Jimma, 2024G.C

Abstract

Background; Anesthetic agents can impair protective airway reflexes, increasing the risk of aspiration and complications like pneumonia. Pre-procedural fasting is crucial, particularly in pediatric patients, to reduce aspiration risk, with specific fasting durations recommended by guidelines, although adherence varies. Objectives: To assess the adherence to pre-operative fasting guidelines and identify the associated factors among elective pediatric surgical patients at Jimma University Comprehensive Specialized Hospital. The study was conducted over a period of four months, from October, 2024 to January, 2025G.C Methods Study Design: A cross-sectional study was conducted on pediatric patients undergoing elective surgery at JUCSH between October 2024 and January 2025. Adherence Assessment: Adherence to preoperative fasting guidelines was evaluated by comparing actual fasting durations to recommended guidelines for clear fluids, solid foods, and breast milk. Population and Sample: The study included 113 pediatric patients scheduled for elective surgery and their primary caregivers, using a descriptive cross-sectional design. Data Collection and Analysis: Data were entered using EpiData version 4.6 and analyzed with SPSS version 27. Bivariate and multivariable logistic regression analyses were used to identify factors associated with adherence, with statistical significance set at p < 0.05 Results: Adherence to fasting guidelines was 25.7% (95% CI: 18.3%–33.1%). The mean age of participants was 3.47 years, with 75.2% male. The main reason for non-adherence was incorrect fasting instructions (64.3%). Factors associated with adherence included age (AOR = 0.690, 95% CI: 0.523–0.909, P = 0.008), prior complications due to non-fasting (AOR = 5.39, 95% CI: 1.07 7.10, P = 0.041), and patient scheduling (AOR = 0.178, 95% CI: 0.032–0.981, P = 0.047). Conclusion: Adherence to fasting guidelines was low. Factors such as age, previous complications, and patient scheduling influenced adherence. Improved education and communication are needed to enhance compliance. Recommendations; Improve surgical scheduling to minimize delays and maintain a structured sequence. Strengthen education programs for parents and guardians regarding fasting guidelines. Future research should explore the long-term impact of adherence on surgical outcomes.