Informed consent for peripheral nerve blocks in patients presenting for upper limb surgery: documentation and patients' knowledge
Date
2016
Authors
Buitenweg, Adriaan Willem
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Abstract
Peripheral nerve blocks for upper limb surgery are commonly performed procedures that are considered very safe but may be associated with significant distress, serious and life threatening complications. The informed consent process, including its documentation, is an ethical and legal requirement to ensure that patients have full knowledge of the possible consequences, risks and benefits of the procedure for which they are granting permission. Numerous previous studies have shown that informed consent is often not obtained and that if attained is often inadequate and poorly documented. The aim of this study was to evaluate the adequacy of the informed consent process among patients receiving peripheral nerve blocks for upper limb surgery at the Chris Hani Baragwanath Academic Hospital Hand Unit. Patients receiving peripheral nerve blocks for upper limb surgery between September 2014 and March 2015 were approached for inclusion in the study. Patients were asked to complete a survey questionnaire and the patients' records were then reviewed to determine if consent was documented. It was found that only 20% of patients had adequate knowledge of the peripheral nerve blocks they had received, and only 44% of these patients had documented consent. None of the patients in the study had documented consent that was adequate according to the standard set out by the HPCSA. This study revealed that patients receiving peripheral nerve blocks for upper limb surgery at the CHBAH Hands Unit currently do not have adequate knowledge regarding the blocks and that documentation of informed consent is inadequate if present at all. 68% of patients requested that an information leaflet be developed and provided to them as part of the informed consent process.
Description
A research report submitted to the Faculty of Health Sciences, University of the
Witwatersrand, in partial fulfillment of the requirements for the degree of Master of
Medicine in Anaesthesiology, Johannesburg, 2016