Understanding Preoperative Instructions

(Originally presented by Dr Mark Azer)

The literature:

• Patients have poor understanding of preoperative instructions
• Recent data suggests:
  • Up to 40% of patients had incomplete understanding of what medications to withhold or continue
  • Up to 50% of patients had incomplete understanding of their procedure indication and risks
  • Up to 4% of patients were non-compliant with fasting instructions

The consequences of poor understanding:

• Clinical – potential for aspiration, poor BSL control and increased bleeding or blood loss
• Legal – ramifications if surgery proceeds without informed consent
• Economic – unexpected cancellations and wasted theatre time
• Patient experience – poor experience and reduced subsequent engagement

Take home messages:

• Adding an explanation or rationale is associated with improved patient understanding
• The older male population are at increased risk for poor medication compliance

Useful links:

• Medication discontinuity errors in the peri-operative period 2010.
• Predictors of patient medication compliance on the day of surgery 2014.