Two third cases come to OT without consent forms

As per a report published in JAMA surgery by Elliott Haut, MD, of Johns Hopkins Hospital, consent forms are missing from the charts for two-thirds of patients who arrived in preop (66%), resulting in delayed operation start times in 14% of cases.

If a missing consent is subsequently obtained by a resident, 40% of hospital faculty they are not usually satisfied with that consent. And 69% said residents should not obtain consent from patients having elective surgery.

Most hospital faculty (70%) also said that they believed that patients preferred to be asked for consent by their surgeon rather than a resident.

Informed consent is the most important conversation that patients have with their surgeons, allowing for autonomy and informed decision making.

The researchers administered a web-based survey to 30 pre-op nurses, 39 surgical residents, and 53 faculty members at a single academic hospital. In addition to collecting 1 week of data on absent surgical consent forms in patients' medical records, they asked about actions following discovery of the missing consent form, and case delays.

1. When a missing consent form was discovered, 72% of nurses said they paged the attending physician.

2. Some 43.2% of residents said they were paged to acquire consent forms at least weekly, while 16.2% were called more than once a week. This resulted in 65.8% of residents being pulled from their rounds or a conference weekly; 13% were pulled away from other work daily.

3. Although most residents said they were comfortable obtaining consent forms for minor procedures (97.4%), less than half (47.4%) said they were comfortable getting consent for major procedures. (MedPage Today)