An audit of consenting practices in a district general hospital. Can we improve?

E, Chohda; Doddi, Seshagiri; Sundaramoorthy, Souganthy; Rn, Manton; Ahad, Md. Atiqur Rahman; Sinha, Ashim; Khawaja, Haseeb

doi:10.11138/gchir/2015.36.6.263

Cited by 5 publications

(5 citation statements)

References 11 publications

(11 reference statements)

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“…Informed consent is a topic that is closely related to both research and clinical practice, since articles focusing on informed consent quality 33 –36 and decisional capacity 37 –39 can be applied to both research and clinical practice. Moreover, Knüppel et al 40 and Landau 41 reinforce the dangers of coercive or incomplete clinical guidelines, in which ethical issues are ignored or misused.…”

Section: Resultsmentioning

confidence: 99%

“…[25][26][27][28][29][30][31][32] In regards to conflicts of interests, several articles explain that sometimes not only researchers have them, but also policymakers can act maliciously or negligently in regards to them. [33][34][35][36][37] Informed consent is a topic that is closely related to both research and clinical practice, since articles focusing on informed consent, quality [38][39][40][41] and decisional capacity [42][43][44] can be applied to both research and clinical practice. Moreover, Knüppel et al 45 and Landau 46 reinforce the dangers of coercive or incomplete clinical guidelines, in which ethical issues are ignored or misused.…”

Section: Literature Review Findingsmentioning

confidence: 99%

“…Also, it will ensure that adequate nursing values do not have to compete with hospital values, boosting their confidence and diminishing their frustration and stress, which consequently could increase nurse retention. Furthermore, CliPEAT also considers and detects problems that other authors have considered to impact nursing practice greatly, such as conflict of interests, [33][34][35][36][37] informed consent [38][39][40][41][42][43][44] and incomplete guidelines. 45,46…”

Section: Implications For Nursing Clinical Practicementioning

confidence: 99%

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The development of a clinical policy ethics assessment tool

et al. 2018

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Introduction: Clinical policies control several aspects of clinical practice, including individual treatment and care, resource management and healthcare professionals’ etiquette. This article presents Clinical Policy Ethics Assessment Tool, an ethical assessment tool for clinical policies that could be used not only by clinical ethics committees but also by policy committees or other relevant groups. Aim: The aim of this study was to find or create a tool to identify ethical issues and/or confirm ethical validity in nursing practice policies, protocols and guidelines. Methodology: The development of Clinical Policy Ethics Assessment Tool involved first a literature review, followed by modification of the Research Protocol Ethics Assessment Tool, which was created to identify research protocols’ ethical issues, and finally, a trial of Clinical Policy Ethics Assessment Tool to ensure its reliability and validity. Ethical consideration: The policies analysed trialling Clinical Policy Ethics Assessment Tool were in the public domain and did not contain any confidential information. Despite that, Clinical Policy Ethics Assessment Tool also had the approval of a research ethics committee. Results: Research Protocol Ethics Assessment Tool was chosen as the template for a Clinical Policy Ethics Assessment Tool, to which several modifications were added to adapt it to work within a nursing practice context. Clinical Policy Ethics Assessment Tool was tested twice, which resulted in a general test–retest reliability coefficient = 0.86, r = 0.84, α1 = 0.817, α2 = 0.824 and interclass correlation coefficient = 0.874. Discussion: Contemporary nursing practice in a developed country is often ruled by clinical policies. The use of Clinical Policy Ethics Assessment Tool could confirm the ethical validity of those clinical practice policies, impacting on nurses’ education, values and quality of care. Conclusion: Clinical Policy Ethics Assessment Tool has the potential to detect ethical issues and facilitate the correction and improvement of clinical policies and guidelines in a structured way. This is especially so as it has shown reliability in detecting issues in clinical policies involving human participants and in encouraging policymakers to consider common ethical dilemmas in nursing practice.

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Section: Resultsmentioning

confidence: 99%

Section: Literature Review Findingsmentioning

confidence: 99%

Section: Implications For Nursing Clinical Practicementioning

confidence: 99%

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The development of a clinical policy ethics assessment tool

et al. 2018

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“…10,11 One study found that only 5% of consent forms audited were legible, complete, written without abbreviations, filed securely, and copied for the patient to take home. 12 Several prospective studies have documented poor parent recall and understanding of the risks and benefits of various medical treatments. 4,13,14 Many factors can impact understanding and comprehension, such as education level, cognitive function, and anxiety.…”

Section: Introductionmentioning

confidence: 99%

“…There can be a high degree of variability in consent quality and documentation 10,11 . One study found that only 5% of consent forms audited were legible, complete, written without abbreviations, filed securely, and copied for the patient to take home 12 . Several prospective studies have documented poor parent recall and understanding of the risks and benefits of various medical treatments 4,13,14 .…”

Section: Introductionmentioning

confidence: 99%

Impact of Using a Precompleted Consent Form for Procedural Sedation in the Pediatric Emergency Department

McCollum,

Silva,

Sigman

et al. 2023

Pediatr Emer Care

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Objectives This study aimed to compare elements discussed during the consent process for procedural sedation in the pediatric emergency department to documentation and parental recall before and after implementation of a standardized consent form. Methods This is a mixed-methods study combining retrospective electronic record review and cross-sectional surveys of providers and parents after consent for procedural sedation. Surveys were obtained before and after implementation of a precompleted consent form. Providers' survey responses were compared with consent documentation. Recall of consent elements discussed by linked parent-provider dyads were compared. Results Six hundred fifty-five encounters were reviewed. Pediatric emergency medicine fellows and pediatric emergency department-based pediatricians were more likely to document any benefit (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.0–2.4) or alternative (OR, 2.7; 95% CI, 1.8–3.9) compared with PEM attendings. Providers were more likely to report discussion of failure to complete the procedure (OR, 7.3; 95% CI, 2.3–23.3) and parents were more likely to recall discussion of this risk (OR, 5.3; 95% CI, 1.0–27.8) in the postintervention group. Based on provider recall, using the precompleted consent form was associated with providers discussing at least 2 of the 3 benefits (84.0% vs 97.2%, P < 0.01), 5 of the 5 risks (31% vs 67.7%, P < 0.01), and improved parental recall of risks (5.7% vs 22.9%, P = 0.03). More providers reported taking less than 1 minute to complete the form in the postimplementation group (12.0% vs 43.7%, P < 0.01). Conclusions Implementing a precompleted consent form for procedural sedation was associated with providers reporting decreased time spent completing the consent form and better alignment of key consent elements between reported provider discussion and parental recall.

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Preoperative informed consent for mandibular third molar surgeries: A survey analysis in a subset of dentists and oral surgeons in Saudi Arabia

Alkindi

2019

The Saudi Dental Journal

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ObjectivesThe objective of this study was to identify patterns of obtaining preoperative informed consent from patients undergoing mandibular third molar surgeries, in a subset of general dentists and oral surgeons in Saudi Arabia, and to compare the consenting patterns based on the clinician’s rank, years of experience, place of work and gender.MethodsA prospective questionnaire based study was designed and data was obtained through an online survey from 102 participants who were selected for the study. Demographic information, clinician experience, type of informed consent obtained and information related to discussion of legal implications and complications were collected. Descriptive analysis of the obtained data and statistical comparisons using cross tabulation and Pearson Chi-Square test with a 95% significance level (P < 0.05) were done between the independents demographic variables and dependent variables pertaining to patterns of preoperative consenting.ResultsThe survey response rate was 81.3% (n = 83), with 59.04% general dentists and 40.96% oral surgeons. The ratio of male to female respondents was approximately 3:1. Majority of the respondents reported a clinical experience of less than 10 years (77.11%) and were reportedly working in the private sector (73.49%). Nearly 80% of the respondents (79.52%) mentioned obtaining preoperative consent for mandibular third molar surgeries and was significantly higher (p-value – 0.018) among clinicians with more than 5 years of experience (90%). While 38.5% of the respondents indicated obtaining both a written and verbal consent, 53.01% obtained only a verbal consent. Majority of the respondents were aware of the legal implications of obtaining informed consent (81.93%) and disclosed incidental complications to their patients (91.57%). However, differences in the perceived post-operative complications associated with mandibular third molar surgeries were observed between general dentists and oral surgeons.ConclusionThe results of this study indicate a good level of knowledge about informed consent for mandibular third molar surgery and its legal implications among the dentists and oral surgeons who were surveyed. However, to avoid painful medico-legal disputes, a written informed consent signed by patients along with a witness should be considered mandatory.

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An audit of consenting practices in a district general hospital. Can we improve?

Cited by 5 publications

References 11 publications

The development of a clinical policy ethics assessment tool

The development of a clinical policy ethics assessment tool

Impact of Using a Precompleted Consent Form for Procedural Sedation in the Pediatric Emergency Department

Preoperative informed consent for mandibular third molar surgeries: A survey analysis in a subset of dentists and oral surgeons in Saudi Arabia

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