Is consent for hip fracture surgery for older people adequate? The case for pre-printed consent forms

Abstract

This work suggests consent forms are completed well with respect to patient identifiers, legibility and procedure. The variability of complications stated is vast. We suggest standard pre-printed consent forms containing risks and benefits should be used as this may improve standards of informed consent. This has also been recently supported by the British Orthopaedic Association.

Consenting Operative Orthopaedic Trauma Patients: Challenges and Solutions

“…The variability of procedure-based risks or complications is vast and, therefore, we suggest the use of available online orthopaedic-basis procedure guideline (Orthoconsent) which has been endorsed and updated by the British Orthopaedic Association [9, 13] to guide and train the junior surgical or orthopaedic trainees to achieve competency in consenting trauma cases when is or are allocated to perform the procedure(s). These information sheets should be reviewed by each department locally, and relevant alterations made.…”

Doctors’ perspectives of informed consent for non‐emergency surgical procedures: a qualitative interview study

“…Most previous studies exploring the consent process for surgical procedures have focussed on patient perspectives and conclude that current consent processes are often inadequate as patients often have limited understanding of the process, are frightened or disempowered by the process, or feel that they have either not understood or not been told relevant information about their treatment. One study which has reviewed consent documents has demonstrated doctors’ variability in covering complications . There has been little exploration of the consent process from the doctors’ perspective; our literature search identified only three previous studies, all of which were conducted in developing countries.…”

The influence of process and patient factors on the recall of consent information in mentally competent patients undergoing surgery for neck of femur fractures

“…This approach has been reported to improve recall rates in patients undergoing knee arthroscopy and arthroplasty 20 . The variability of the information recorded on ordinary consent forms by junior staff lends support to the use of such printed and standardised consent forms 12,20,21 . This would also resolve typographical issues such as legibility, corrections, overwriting and the use of abbreviations.…”

“…The information provided to hip fracture patients at the time of consent is variable and not always standardised or reasonably adequate 12–14 . The most frequent and consistently communicated possible risks include infection, venous thromboembolism, neurovascular damage, anaesthetic risks, chest infection, myocardial infarction and scar problems.…”

“…Previous studies have reported the inadequacy of the consent process in NOF patients 12–14 . The adequacy and validity of consent are, however, not surrogates for the patient’s comprehension and retention of the presented information, which are purely ‘patient’ factors.…”