Impact Snapshot

Implementing ‘SipTilSend’: Enhancing Pre-Surgery Patient Comfort and Safety

Project Location(s): Sydney Local Health District (SLHD)
Project Lead(s): Dr Oya Gumuskaya, A/Prof. Sarah Aitken

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This project piloted and evaluated the local implementation of the ‘SipTilSend’ model of care to replace traditional prolonged fasting practices prior to surgery. The study assessed the feasibility, safety, and impact of this change on patient outcomes and surgical care processes to support broader implementation across Sydney hospitals.

The Challenge

SipTilSend involves encouraging patients to take small sips of clear fluid ahead of being transferred to the operating theatre. Despite evidence from UK research that prolonged pre-surgical fasting can worsen patient experience and increase the risk of complications, entrenched perioperative practices—particularly the widespread use of ‘Nil by Mouth from Midnight’ protocols—remained resistant to change and were viewed as fixed.

The Approach

The project was conducted initially within RPA and Concord, before being implemented at Westmead, Nepean, Blacktown and Royal North Shore hospitals. It involved structured engagement, interprofessional education, and consumer-informed messaging developed in co-design workshops, to improve understanding of the evidence supporting more liberal pre-operative clear-fluid intake. Consumer engagement sessions informed implementation (Concord, Blacktown, Royal North Shore).

Sydney Health Partners Support

Clinical Academic Group

  • Identified as a priority by SHP’s Perioperative CAG with $19,000 provided for workshops, resources and consumer involvement in 2024/2025. Dr Gumuskaya was also awarded the SHP’s Perioperative CAG’s Emerging Clinical Researcher Award in 2024.

Impact as of 2026

  • The project began as a single-site local initiative at Concord Hospital and was expanded across five hospitals – RPA, Blacktown, Nepean, Westmead and North Shore Hospitals.
  • Provided evidence of an improved patient experience and a safer approach to surgical preparation with less than 1% of patient participants experiencing surgical delays or cancellations.
  • The project team is establishing a context specific implementation model that can be adapted by other fast-paced healthcare environments.

Key Publication

Oya Gumuskaya, Hailey R. Donnelly, Nick Glenn, Julee McDonagh, Anita Skaros, Sophie Liang, Brett G. Mitchell, Luke Bendle, Sarah Aitken, Emile Belramoul, Mitchell Sarkies (2026). The effectiveness of preoperative oral carbohydrate loading on postoperative nausea and vomiting in adults receiving total intravenous anaesthesia compared to inhalational anaesthesia: A systematic review and meta-analysis. Journal of Clinical Anesthesia Volume 108, January 2026, 112075 https://doi.org/10.1016/j.jclinane.2025.112075

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Programs

Clinical Academic Group, Implementation Science Academy

Clinical Academic Group

Perioperative Care

Partner

Sydney Local Health District (SLHD)
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