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)
