Discussion on Informed Consent

Participation Requirement: You are required to post a minimum of three (3) times in each discussion. These three (3) posts must be on a minimum of two (2) separate days. You must respond to the initial discussion question by 11:59 p.m. on Wednesday.  On additional days, respond to your peers’ posts as well as additional faculty posts. Responses to peers must be posted by 11:59 p.m. on Sunday each week a discussion is due.

Step 1: Read the attached article entitled, “Informed Consent – The Joint Commission” 

Step 2: View the video entitled, “Nursing Fundamentals: Informed Consent, Advance Directives, Reporting and Nursing Documentation”https://www.youtube.com/watch?v=9u53jNI4qoU (Links to an external site.)

Informed consent is obtained after a client receives complete disclosure of all pertinent information provided by the provider regarding the surgery or procedure to be performed. The nurse may obtain informed consent only after the client verbalizes understanding of the potential benefits and risks associated with the surgery or procedure.

Elements of Informed Consent:

1. The individual giving consent must fully understand the procedure that will be performed, the risks involved, expected/desired outcomes, expected complications/side effects, and alternative treatments or therapies available.
2. Consent is given by a competent adult, legal guardian or designated power of attorney (DPOA), emancipated or married minor, parent of a minor, or a court order.
3. A trained medical interpreter must be provided when the person giving consent is unable to communicate due to a language barrier.
4. The nurse’s role is to witness the client’s signature and ensure the provider gave the necessary information and that the client understood and is competent to sign. If it has been identified that the client does not understand the procedure or is not competent to sign the informed consent, the nurse must STOP the process and the physician must be notified immediately.

A consultation occurs when a professional provides expert advice in a particular area and determines what treatment or services the client requires. The nursing intervention evolves around facilitating coordination with other health care providers throughout the continuum of care in order to protect the client from conflicting and potentially dangerous treatments.

A referral is a formal request for a special service by another care provider so that the client can access the care identified by the primary care provider or consultant. Some examples of referrals include physical therapy, wound care, and hospice. The nursing intervention continues to evolve around monitoring the client’s response and progress.

Directions: There are three scenarios that will be used in this discussion posting. You are all responsible for the initial discussion posting and then responding to one posting in the remaining scenarios. For example, my last name is Combs, therefore my initial discussion posting will occur from CASE #1. I will then be responsible for responding to one post from CASE #2 and one post from CASE #3.

CASE #1 (A to H); CASE #2 (I to Q); CASE #3 (R to Z)

CASE #1:

30-year-old male presents to the emergency department with RLQ pain and fever. Labs reveal an elevated white blood count. The surgical intern tells the patient that appendicitis is suspected and that the plan is to proceed with surgery to remove the appendix. He explains that the surgery is to be performed to prevent complications of appendicitis, including abscess formation, sepsis or even death. He goes on to explain the risks of surgery, including bleeding, infection and damage to adjacent organs. What additional information needs to be included in this consent? Provide an evidence-based reason for your answer.

1. Whether or not the intern would undergo the procedure in a similar circumstance.
2. Alternative to the surgery, including receiving antibiotics and monitoring the patient.
3. Name of the surgeon who will actually be performing the procedure.
4. A, B and C
5. B and C only

CASE #2:

33-year-old woman is in the operating room to undergo colectomy for ulcerative colitis. Patient was given appropriate information, and consented for the procedure. During the operation, a mass is identified involving the liver. Given the previous consent, it is acceptable for the surgeon to proceed further to either biopsy or excise the lesion. Provide an evidence-based reason for your answer.

1. True
2. False

CASE #3:

14-year-old girl presents to the emergency department, accompanied by her 10-month-old daughter and boyfriend. The boyfriend is the child’s father. Patient complains of severe lower abdominal pain, although she is afebrile, with normal laboratory values and normal vital signs. No cause of the pain is able to be delineated, and the plan is to take the girl to the operating room to perform a diagnostic laparoscopy. In this case, from whom should informed consent be obtained? Provide an evidence-based reason for your answer.

1. Patient
2. Patient’s parents
3. Patient’s boyfriend

Informed Consent – The Joint Commission.pdf