A literature review indicates that patients continue to fast for prolonged periods from both food and fluids before surgery. Research findings on preoperative fasting for elective surgery are not being applied in the clinical setting. Developing evidence-based preoperative fasting policies alone will not assist in bringing change to the traditional practice of routine nil per os (NPO) after midnight. Health care organisations should educate patients and staff on evidence-based preoperative fasting guidelines and implement change management processes to change preoperative fasting practices.