Changes on Operative Consents

[TX_RN_CAPA]

Need some feedback on what others do when confronted with a consent that needs to be corrected. We have had several episodes where the surgical consent was signed by the patient during the preadmission visit but when the chart is reviewed prior to being sent to the Preop unit for admission, an error is discovered (missed word, transposed diagnosis and procedure, seriously misspelled words affecting the meaning). The patient is no longer available at this point.

We are having a debate on what to do with the signed consent that's on the chart. The debate is whether it's best to remove the incorrect consent and throw it out or leave it on the chart and have a new one signed when the patient arrives. We have checked with risk management - got no definitive answer. Options for leaving it in place include putting a post-it note on the consent with a note to correct (could fall off), placing a large red X across the form, etc. What does everyone else do in this situation?

Any feedback would be appreciated.

Susan

[sharann, BSN, RN]

Doesn't the OR nurse have to check the consent prior to taking the patient back to surgery? Why isn't the consent with the pt at all times on the chart? Maybe I am missing something? Need more info.

[carcha]

Yeah, TX, RN, we have this problem ALL the time. I just cannot understand how the medical personnel can make such a mess of such an important document. For the most part we ask the surgeon to correct the mistake in front of the patient , while an or nurse is present then the patient will initial it to show they were aware. Not great but the only other alternative is to send the patient back to the unit for surgery another day. Our only exception is a patient who is confused, or very young or someone who has had a premed. In that case we send the patient back until the premed has worn off, or a family member and the risk management are informed of the situation. It causes a whole lot of trouble here yet is still going on!