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Consent for orthopaedic trauma surgery during the COVID-19 pandemic

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Title: Consent for orthopaedic trauma surgery during the COVID-19 pandemic
Authors: Selmi, H
Davies, A
Walker, J
Heaton, T
Sabharwal, S
Dani, M
Fertleman, M
Reilly, P
Item Type: Journal Article
Abstract: INTRODUCTION: The COVID-19 pandemic has brought a series of new challenges to the management of surgical patients. The consent process relies on a foundation of open and non-coerced discussion between clinician and patient, which includes all the potential risks of surgery. This must be updated to incorporate the additional risks of surgery during the pandemic including infection with the SARS-CoV-2 and increased risks of complications with the potential requirement for intensive care support. AIM: The aim of this multi-cycle quality improvement project was to ensure all patients were fully informed of the risks of developing COVID-19 and the possible need for intensive care unit (ICU) support. METHODS: We investigated the quality of the consent process for patients undergoing surgery for trauma at our major trauma centre. Our baseline data collection included a review of all orthopaedic trauma consent forms over a 4-week period in March 2020. We subsequently undertook three further Plan-Do-Study-Act (PDSA) cycles over separate 4-week periods. First, in June 2020, after education measures and presentation of baseline data, second in July 2020 after further education and regular digital reminders were sent to staff, and third in September 2021 after the implementation of an electronic consent form. RESULTS: At baseline, only 2.6% of consent forms mentioned the risk of COVID-19 and none mentioned the risk of requiring ITU support. Through three PDSA cycles this increased to 97% of cases where consent forms displayed the additional risks of COVID-19 and the potential need for ITU admission. CONCLUSION: Our quality improvement project improved the informed consent procedure at our trust. By incorporating these additional risks into the template of an electronic consent form, we hope to achieve sustained improvement in practice.
Issue Date: 30-Jun-2022
Date of Acceptance: 8-May-2022
URI: http://hdl.handle.net/10044/1/98024
DOI: 10.1136/bmjoq-2021-001778
ISSN: 2399-6641
Publisher: BMJ Publishing Group
Journal / Book Title: BMJ Open Quality
Volume: 11
Issue: 2
Copyright Statement: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Keywords: COVID-19
Healthcare quality improvement
Informed Consent
Healthcare quality improvement
Informed Consent
Publication Status: Published
Conference Place: England
Article Number: ARTN e001778
Online Publication Date: 2022-06-30
Appears in Collections:Bioengineering
Imperial College London COVID-19

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