Assessing the quality of consent in elective hip and knee arthroplasty: Do modern orthopaedic surgeons make the cut?

Heylen, Joseph; Antoniou, Vaki; Roberts, J; Kemp, Oliver; Morris, James C.; Vats, Amit

doi:10.1016/j.jcot.2021.101604

Cited by 2 publications

(3 citation statements)

References 19 publications

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“…This audit has several strengths. First, this study has a relatively large sample size as compared to other similar audit study (4)(5)(6)(7)(8)(9). Study with a larger sample size allows generation of more representative and generalizable results.…”

Section: Discussionmentioning

confidence: 99%

Audit on Validity and Adequacy of Consent Forms for Ophthalmology Laser Procedures and Angiography in a Tertiary Hospital

Tham,

Mohd Taufik,

Ong

et al. 2023

JUMMEC

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The importance of complete and valid written consent for medical procedure is indisputable. Written consent forms for ophthalmology related laser procedures and angiography were audited against guidelines regarding validity and adequacy. A full cycle clinical audit was carried out at a tertiary hospital providing ophthalmology service. A preintervention audit was performed in 2018 where consent forms of all ophthalmology related laser procedures and angiography were reviewed. Multiple interventions were taken to improve the adherence in obtaining a valid and adequate written consent prior to the post intervention audit. Standards of practice were compared to ‘Guidelines for Consent for Treatment of Patients by Registered Medical Practitioners’ by Malaysian Medical Council (MMC), and ‘Consent Forms in Ophthalmic Practice’ by Dr. Amit Khosla. A total of 412 consent forms were reviewed in the pre-intervention audit of 2018. Adherence to standard was 37.14%. In the post intervention audit, 256 forms were reviewed, and the adherence improved to 85.94%. Interventions taken include briefing to stakeholders, formulating a standardized risks checklist and multiple checks were done to ensure the interventions were adhered to by the doctors. The significant improvement in adequacy and validity of consent taking for ophthalmology related laser procedures and angiography showed that the interventions taken, were indeed useful. However, continuous effort in maintaining the standard is crucial for patient care and safety.

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Section: Discussionmentioning

confidence: 99%

Audit on Validity and Adequacy of Consent Forms for Ophthalmology Laser Procedures and Angiography in a Tertiary Hospital

Tham,

Mohd Taufik,

Ong

et al. 2023

JUMMEC

View full text Add to dashboard Cite

show abstract

“…Previous studies have also shown that handwritten consent forms in orthopaedics often have insufficient procedure-related information [ 11 , 12 ]. Our findings indicate that the designation and seniority of the person filling out the form did not improve information on the form, showing that it is not a lack of knowledge, but rather factors of time constraints and recall, which may be responsible.…”

Section: Discussionmentioning

confidence: 99%

“…Our findings indicate that the designation and seniority of the person filling out the form did not improve information on the form, showing that it is not a lack of knowledge, but rather factors of time constraints and recall, which may be responsible. Studies have recommended using standardized pre-written consent forms to ensure comprehensive information is provided to patients [ 11 , 12 ]. These have also been shown to improve patients’ retention of information and understanding of the procedure [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

The Consent Process for Elective Hip and Knee Arthroplasty: Does Information on Handwritten Forms Meet Prescribed Standards?

Sharma¹,

Adelowo²,

Bindumadhavan³

et al. 2022

Cureus

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Introduction The process of informed consent is vital, not only to good clinical practice and patient care, but also to avoid negligence and malpractice claims. Elective hip and knee arthroplasty numbers are increasing globally, and the British Orthopaedic Association (BOA) has endorsed standards for obtaining written consent for these procedures. Many centres in the United Kingdom and globally, use handwritten consent forms to document informed consent, leaving open the potential for missing out important procedure and risk-related information. Our study aimed to assess whether information on handwritten consent forms was compliant with BOA standards for elective arthroplasty of the hip and knee. Methods We retrospectively reviewed 70 handwritten consent forms, across theatre lists of 12 arthroplasty consultants at our elective arthroplasty centre. These included 35 forms each for hip and knee arthroplasty respectively. We compared the information on these forms to the standards prescribed by the BOA. We assessed compliance of the forms with common, less common and rare risks of hip and knee replacement, as described by the BOA. We also noted the designation of the person filling out the form (consultant, registrar or nurse practitioner) and whether this affected information on the form. We assessed the forms for legibility issues, and whether the setting (clinic/pre-operative ward) affected information on the form. Results None of the 70 forms reviewed achieved full compliance with BOA standards. When assessed for common risks of hip and knee arthroplasty, the number of compliant forms was 25.7% and 42.8%, respectively. None of the forms mentioned all rare risks of either hip or knee arthroplasty. We identified legibility issues in 12 of 70 (17.1%) forms. There was no significant difference in information written on forms filled out by consultants, registrars or nurse practitioners, or between forms filled out in the clinic versus those on the pre-operative ward. Conclusion Handwritten forms lack compliance with prescribed standards for written informed consent in elective hip and knee arthroplasty. Ideally, a pre-written consent form should be used, but with the option of adding information individually tailored to the patients’ background. This ensures that good clinical practice is optimally followed, and reduces the potential risk of any litigation.

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Assessing the quality of consent in elective hip and knee arthroplasty: Do modern orthopaedic surgeons make the cut?

Cited by 2 publications

References 19 publications

Audit on Validity and Adequacy of Consent Forms for Ophthalmology Laser Procedures and Angiography in a Tertiary Hospital

Audit on Validity and Adequacy of Consent Forms for Ophthalmology Laser Procedures and Angiography in a Tertiary Hospital

The Consent Process for Elective Hip and Knee Arthroplasty: Does Information on Handwritten Forms Meet Prescribed Standards?

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