consent for common obstetric and gynaecological procedures l.
Skip this Video
Loading SlideShow in 5 Seconds..
Consent for Common Obstetric and Gynaecological Procedures PowerPoint Presentation
Download Presentation
Consent for Common Obstetric and Gynaecological Procedures

Loading in 2 Seconds...

  share
play fullscreen
1 / 22
Download Presentation

Consent for Common Obstetric and Gynaecological Procedures - PowerPoint PPT Presentation

albert
460 Views
Download Presentation

Consent for Common Obstetric and Gynaecological Procedures

- - - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

  1. Consent for Common Obstetric and Gynaecological Procedures Presented by Dr Stella Mwenechanya Calderdale and Huddersfield NHS Trust

  2. Aims and objectives • Compliance of current practice to GMC/RCOG advice • Looking at process, documentation • More specifically: • Who is taking consent • Serious and frequent risks documented.

  3. Background and Standards • Legal document may help reduce complaints/litigation • GMC: informed consent • By investigator/operator • Delegation to suitably qualified and trained person • Sufficient knowledge of procedure and risks

  4. Standards • RCOG consent advice given on several gynae procedures and C/S • Based on DOH/welsh assembly consent form 1 • Advice on risks to be discussed for each procedure also given.

  5. Method • Retrospective review of cases July and August 2007 • August: new SHO intake • July: SHOs in post atleast 4 months  Theatre Registers • Procedures looked at were • Abdominal hysterectomy for heavy periods • Caesarean section • Diagnostic hysteroscopy • Diagnostic laparoscopy • Laparoscopic tubal occlusion • Pelvic floor repair and vaginal hysterectomy for prolapse

  6. Information looked at Patient identification Name and benefits of procedure Serious and frequently occurring risks Extra procedures to/not to be carried out Leaflet Anaesthetic Health professional completing the form compared to performing the procedure and their competency Patient signature Confirmation of consent

  7. Results • 57 cases analysed. (10 C/S) • 100% compliance in: • Patients’ surname, first name, DOB and NHS/hosp number • Name of procedure • appropriate benefits • 28%(16) named consultant

  8. Risks • Serious and frequent risks discussed in 98% • Documentation variable for: • Procedure specific risks • Additional procedures • 18% of consent forms contained none

  9. Abdominal Hysterectomy

  10. Caesarean Section

  11. Diagnostic Hysteroscopy

  12. Diagnostic Laparoscopy

  13. Laparoscopic Tubal Occlusion

  14. Pelvic Floor Repair & Vaginal Hysterectomy

  15. Leaflet/Anaesthetic 32%(18) Leaflet 79%(45) type of anaesthetic ticked

  16. Doctor Signature/Date/Name/Position • 96%(55) Signed and Dated • 93% Printed name (legible) • 19% were complete by consultants • 21% by associate specialists • 46% by registrars • 7% by SHOs • 43%(25) completed by the health professional performing the procedure

  17. Competency • 94%(54) competent to perform the procedure • 3 VTS SHOs • 2 c-section • 1 diagnostic laparoscopy

  18. Patient Signature/Date/Name 96%(54) Signed 84% Dated 68% Name printed

  19. Conclusion • Good compliance with guidelines on documentation of • patient/procedure details • Procedure benefits • Person obtaining consent • Serious and frequent risks • Reasonable compliance with local guidelines • Poor compliance with RCOG • Compliance also to be improved in: • Leaflets provision/documentation • Anaesthetic discussion • Named consultant

  20. Recommendations • Use of procedure specific consent forms to ensure all risks discussed with patient. • May even reduce repeat C/S rate • Registrar Inductions to include guidelines in obtaining valid consent. • Audit of local risks for each procedure. • Re-audit in 3years

  21. Setting standards to improve women’s health Royal College ofObstetricians andGynaecologists Risk Management and Medico-Legal Issues In Women’s Health Joint RCOG/ENTER Meeting Please turn off all mobile phones and pagers