Healthcare

Leadership for implementing new fasting guidelines in NHS Trust

Introduction

This essay discusses the ways in which leadership initiative can bring about organization change in implementing guidelines for fasting in an NHS trust. It had been a common occurrence that prolonged fasting periods for the patients who suffer from trauma and orthopedics in the trust which can be evidenced with many highlights that reflect such a poor practice. Here, the specialist role of a nurse as a change agent is examined with the help of Lewin’s Force Filed Change Model along with the various factors that could influence the process.

Background

It is a very important daily practice for a nurse in the surgical ward is to be responsible for the patients who are on fasting prior to the anesthetic for surgery. This practice has emerged as a routine after an incident when a patient died following anesthetic with chloroform (Simpson, 1848). This practice is justified because of the possibility of aspiration pneumonia also called Mendelson’s syndrome (a serious complication when stomach contents aspire to the lungs) (Mendelson, 1946). According to Roberts and Shirley (1974), the safe level of fluid in the stomach to be remained or the volume of residual gastric was 25ml, PH value over 2.5 and food particles not above 2mm, which had been made clear followed by observation of studies in the animals. Beumont, 1883 cited Green et al, 1996 identified that food and fluids carry different times to empty from the stomach. According to the type of the meal and its quantity it takes up to six hours for the food to disappear from the stomach (Chapman, 1996; Hung, 1992). Fat and cellulose take longer time while proteins and carbohydrates leave the stomach quickly. According to Maltby et al (1998) various researches highlighted that an ingestion of 150 ml clear fluid 2-3 hours prior to surgery would decrease the stomach content volume and enhance the pH level....