Patient Education: Setting Sedation Expectations Pre-Op

Effective preoperative education significantly reduces patient anxiety, improves safety outcomes, and minimizes costly last-minute cancellations. Establishing a structured patient education protocol ensures that patients are informed, prepared, and confident about their upcoming procedure. This article outlines best practices for delivering clear, consistent, and comprehensive pre-anesthesia education.

Start Early During the Scheduling Process

Education should begin as soon as the procedure is scheduled. Front-desk or scheduling staff should verify the patient has a responsible adult escort for the day of surgery. They should also collect baseline health information such as allergies, history of obstructive sleep apnea, or recent respiratory illnesses.

Fasting instructions should be tailored based on the planned level of sedation or anesthesia. The traditional “nothing by mouth after midnight” rule is outdated. Instead, patients should be advised based on ASA and institutional guidelines. For example, clear liquids may be permitted up to two hours prior to the procedure for most cases.

Patients should receive links to educational materials via email or SMS. Providing resources at the time of scheduling reduces confusion and improves patient compliance.

Utilize Multiple Communication Formats

Patients retain information in different ways. A multi-format approach increases understanding and recall. Consider offering:

• Printed educational handouts that can be displayed at home
• Short instructional videos that address common concerns, such as IV placement or recovery expectations
• Two-way SMS reminders to answer basic questions and reinforce key points
• Patient portal messages summarizing medication and fasting instructions

Combining these methods ensures patients are better prepared and reduces the burden on clinical staff during preoperative visits.

Core Education Topics to Address

Your patient education content should include the following:

1. Levels of Sedation
   Explain the differences between minimal, moderate, deep, and general anesthesia in plain language.
2. Fasting and Hydration Guidelines
   Outline specific cutoffs for clear liquids, breast milk, and solid foods. Most patients can consume clear liquids up to two hours before anesthesia, breast milk up to four hours prior, and a light meal up to six hours beforehand.
3. Medication Instructions
   Inform patients which medications to continue or hold, especially those related to blood pressure, diabetes, and anticoagulation. These should be reviewed in coordination with the anesthesia provider.
4. Arrival and Logistics
   Provide arrival time, parking instructions, and a checklist of items to bring such as ID, insurance card, and a list of current medications.
5. Postoperative Expectations
   Set realistic expectations regarding post-anesthesia effects such as grogginess, mild sore throat, nausea, and restrictions on driving or returning to work.
6. Emergency Contact Guidelines
   Clearly state when to contact the clinic or seek emergency medical attention for symptoms like difficulty breathing, uncontrolled pain, or excessive bleeding.

Use bullet points and headers to improve readability. Avoid dense paragraphs that may be overlooked by patients.

Implement Teach-Back for Better Retention

The teach-back method is a proven approach to improving patient comprehension and retention. Ask the patient or caregiver to repeat critical information in their own words. For example, you may ask, “Can you explain when you will stop eating or drinking and who will be driving you home?” This technique improves adherence and can reduce perioperative complications.

Make a Day-Before Confirmation Call

A preoperative call placed 24 hours before the procedure is an essential safety measure. This call can uncover new symptoms such as illness, confirm fasting compliance, and verify transportation plans. Standardized scripting improves consistency. Document patient responses in the electronic medical record for CRNA or anesthesia provider review.

Postoperative Follow-Up Improves Outcomes

A follow-up call by a nurse or CRNA within 24 hours of discharge helps identify early complications and enhances the patient experience. This call also offers an opportunity to collect data on common postoperative concerns such as nausea, pain control, or confusion. Tracking these trends can guide future improvements in protocols.

Use Automated Digital Reminders

Automated appointment reminders are a cost-effective way to reduce no-shows and late arrivals. Effective reminder sequences typically include:

• A message sent three days before with fasting and medication instructions
• A message one day prior with arrival time and directions
• A final message two hours before asking for confirmation of arrival plans

Clinics that use multi-point reminder systems report significant improvements in on-time arrivals and overall patient preparedness.

Monitor Key Metrics to Evaluate Success

To measure the effectiveness of your patient education program, monitor the following metrics regularly:

• Cancellation rates due to incomplete preparation
• On-time arrival rates
• Patient satisfaction scores from Press Ganey or HCAHPS surveys
• Call volume related to pre-op questions that should have been addressed in materials

Use this data to refine your process and update materials as needed.

Conclusion

Preoperative education is an essential component of safe and efficient surgical care. When implemented thoughtfully, it builds trust, reduces cancellations, and improves patient satisfaction. A structured program that begins at scheduling and continues through recovery provides the clarity patients need and the consistency clinical teams rely on.