AIM: To audit documentation of the process of informed consent in patients undergoing vascular surgical and radiological procedures. METHOD: A retrospective audit of randomly selected elective vascular radiological and surgical admissions was undertaken at Christchurch Hospital (Christchurch, New Zealand) to assess documented evidence of the consent process. Clinic letters, handwritten entries in patient notes, and consent forms were scrutinised and data collated on which medical practitioners took consent, what details of the consent process were documented, and what additional information was made available to patients. RESULTS: 100 sets of notes were reviewed (surgical n=51, radiological n=49). For patients undergoing vascular surgery, the consent form was signed by a consultant in 2 (4%) sets of notes compared to 46 (94%) for patients undergoing vascular radiological intervention (p<0.001). All radiology consent forms were signed on the day of the procedure whereas 43 (84%) of surgical consent forms were signed before the day of surgery (p<0.01). Documentation that risks had been discussed with the patient was present in 44 (86%) sets of surgical notes compared to 20 (41%) radiology notes (p<0.001). Additional information (e.g. College of Surgeons' information leaflets) was supplied to 6 (12%) surgical patients and none of the patients undergoing radiological intervention (p<0.05). CONCLUSIONS: In our centre, documentation of the process of informed consent compares favourably with the published literature. This study demonstrates significant differences in documentation between surgery and radiology.
AIM: To audit documentation of the process of informed consent in patients undergoing vascular surgical and radiological procedures. METHOD: A retrospective audit of randomly selected elective vascular radiological and surgical admissions was undertaken at Christchurch Hospital (Christchurch, New Zealand) to assess documented evidence of the consent process. Clinic letters, handwritten entries in patient notes, and consent forms were scrutinised and data collated on which medical practitioners took consent, what details of the consent process were documented, and what additional information was made available to patients. RESULTS: 100 sets of notes were reviewed (surgical n=51, radiological n=49). For patients undergoing vascular surgery, the consent form was signed by a consultant in 2 (4%) sets of notes compared to 46 (94%) for patients undergoing vascular radiological intervention (p<0.001). All radiology consent forms were signed on the day of the procedure whereas 43 (84%) of surgical consent forms were signed before the day of surgery (p<0.01). Documentation that risks had been discussed with the patient was present in 44 (86%) sets of surgical notes compared to 20 (41%) radiology notes (p<0.001). Additional information (e.g. College of Surgeons' information leaflets) was supplied to 6 (12%) surgical patients and none of the patients undergoing radiological intervention (p<0.05). CONCLUSIONS: In our centre, documentation of the process of informed consent compares favourably with the published literature. This study demonstrates significant differences in documentation between surgery and radiology.