Informed Consent + Documentation Flashcards
Informed consent is specifically for …
invasive procedures
not needed for:
bladder cath, NG intubation, venipuncture in hospital/inpatient setting
emergent procedures/if pt is unable to give consent due to injury
Informed consent should be obtained by who?
the physician
What are the components of the informed consent?
dx or likely dx
proposed tx or procedure
alt tx options
risk/benefits
risk of refusing
Where does your dx go?
assessment and procedure note
What is important to do after give the pt the information?
give them time to decide; maybe step out of the room
and remember, they can change their mind at any time
What are the key parts of pt autonomy?
pts can ask questions
pts should know who will be in the room
pt can refuse
pt may want a third party there or not
pt can withdrawal consent at any time (consent form should remain in the chart, additional documentation about the change in tx plan will need to be included)
What are the guidelines about gloves and hand washing?
Where do you put the info about what happened?
procedure note
who was there? who assisted? what specific risks were discussed?
The person performing the procedure has a legal and ethical responsibility to ____.
follow up with the patient
