Ep029: Obtaining Informed Consent

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        • What is informed consent?  Basically the patient is giving permission for treatment and acknowledging that they understand the risks and benefits of the procedure as well as the consequences for not receiving the treatment.
        • Wikipedia
        • The patient must be an adult that is mentally and emotionally competent to sign their own consent
          • Those that may not be able to consent for themselves:  unconscious, declared incompetent, under the influence of medications/alcohol/illegal drugs, or mentally impaired (for example, advanced dementia)
        • Questions must be answered
        • It is also signed by the health care provider performing the procedure and an adult witness (many times the nurse is the witness)
        • It is a LEGAL document
        • Identify appropriate person to provide informed consent for patient
          • The patient should always consent if it is medically appropriate
          • parent, legal guardian, health care power of attorney, next of kin
          • If patient is unable to consent themselves, you may need to reference advanced directives or work with case management to determine the appropriate person to get consent from
        • Make sure to use an appropriate interpreter if English is not the patient’s primary language
          • Interpreter must be from the facility, not the patient’s loved ones
        • There are different kinds of consent
          • Admission / consent to treat
          • Immunization
          • Blood transfusion
          • Surgical
          • Research
          • Special consents: organ donation, autopsy, restraints, photographs, food from home, and many others
        • It is really important to make sure the patient understands the procedure both at the consent is obtained and continually after
        • Consent should be placed in the chart – they are extremely important
        • Patient example:
          • A patient is admitted to the ICU for an obstructed bowel
            • An admission / consent to treat is obtained
          • The patient needs 2 units PRBC’s
            • The nurse obtains a consent to transfuse blood products
          • The patient needs to go to surgery for a bowel resection
            • The surgeon and nurse obtain consent for surgery
          • The patient has complications and qualifies for a research study
            • The patient signs consent for the study
          • The patient codes after surgery and has an anoxic brain injury; declared brain dead and is now an organ donor
            • The HCPOA signs consent for donation

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