Written consent forms

My question is with regard to having patients signing consents prior to procedures. It used to be, back in the day, all we had to think about were surgical procedures. Now (and for good reason) we are having patients sign prior to receiving blood transfusions. However, there are so many new procedures and it seems I am coming across some that do and some that don't require written consent. I would think anything invasive or anything requiring sedation/analgesia requires written consent; is that the best way to know? Also, so many times, I am told to hurry and get the patient to sign a consent BEFORE the surgeon has discussed the procedure, let alone the risks and benefits, to the patient. We are told, "Oh, that will be gone over in the holding area or just before surgery". Needless to say, I am not comfortable with this.
Also, our ICU unit has no set written policies (that I can find) regarding which procedures require patients to be NPO prior to procedures and for how many hours, which procedures allow for a clear liquid breakfast, etc. Anybody out there well versed on this? I sure would appreciate any input.
Every intervention we do requires consent, although not always written consent. You'd think what requires written consent would be more standardized, but it's not, CMS leaves it largely up to Hospital policy to specify what procedures require written consent. In general, facilities define it as any procedure that has more than very benign risks, anything that changes body structure or function, etc. You should never have a patient sign a consent if they have not discussed the procedure with the Physician first. I don't know why pre-procedure staff had such a hard time understanding this, but they have the same problem at my facility as well. We don't allow the patient to go to the pre-procedure area until the Physician has discussed it with the patient unless it's emergent.Pre-procedure NPO policy probably wouldn't be an ICU specific policy, you should be able to find it as a hosptial-wide or surgical services specific policy. "NPO after midnight" used to be the common policy, although EBP nowadays is for something along the lines of 2-4 hours prior for clear liquids, 6 hours prior for a snack and 8 hours for a full meal.

Thank you. I think I"d have an easier time finding procedural NPO status information if I went up to med/surg floor and snooped through their P/Ps. One more question, what is EPB? Again, thank you for all the information. Kudos to you!

EBP=Evidence Based Practice. Here is the American Society of Anesthesiologists recommendations based on the available evidence: http://www.google.com/url?sa=t&sourc...B_CmHHVJiAN7-A

evidence best practice

Got it, thanks!

We sometimes send them to holding without a consent because the surgeon has not discussed the procedure with the patient yet. No problem- they can consent the patient up there.

Our policy, written by our ethics committee, is that patients should not be moved to the pre-op area until they have consented to the procedure. Their view (and mine) is that a consent signed in the pre-op area for a non-emergent procedure is essentially a consent signed under coercion, with sort of defeats the purpose of consent.

MunroRN,I agree with you at post 7. Informed consent implies there is no preassure or hurry to the patient signing the form.

First off nurses are not supposed to have the consent form signed. They are suppose to check to make sure that it is signed. Signing the consent is the surgeon's responsibility. If you are obtaining signatures for informed consent , then, you are practicing out of your scope of practice! Not to mention, if the surgeon has not explained the procedure PRIOR to the signing of informed consent than the patient has not been informed. This is illegal! NPO status in adults: fast for 8 hours after eating fatty foods and 4 hours after ingesting dairy products. Most patients are allowed clear liquid up to 2 hours before an elective procedure.

Quote from MunoRNOur policy, written by our ethics committee, is that patients should not be moved to the pre-op area until they have consented to the procedure. Their view (and mine) is that a consent signed in the pre-op area for a non-emergent procedure is essentially a consent signed under coercion, with sort of defeats the purpose of consent.

Quote from loveslifeFirst off nurses are not supposed to have the consent form signed. They are suppose to check to make sure that it is signed. Signing the consent is the surgeon's responsibility. If you are obtaining signatures for informed consent , then, you are practicing out of your scope of practice! Not to mention, if the surgeon has not explained the procedure PRIOR to the signing of informed consent than the patient has not been informed. This is illegal! NPO status in adults: fast for 8 hours after eating fatty foods and 4 hours after ingesting dairy products. Most patients are allowed clear liquid up to 2 hours before an elective procedure.