Informed Consent Question

[NickiLaughs, ADN, BSN, RN]

Hello all!  We've recently had some arguments about informed consent for endoscopy procedures mainly in the inpatient setting.

Sometimes our patients are poor prep & we need to rescope them the next day.  Because it's often less than 24 hours there's a debate of whether or not we can consent them again.  Additionally we've had patients who went to cath lab or IR the night before and it's also been less than 24 hours for that.

We tried to look through policies and we can't find anything that addresses this.

How does your facility handle these situations where they have multiple procedures over their hospital stay that all require informed consent but sedation is occurring with each of these?

[hppygr8ful, ASN, RN, EMT-I]

NickiLaughs said:

Hello all!  We've recently had some arguments about informed consent for endoscopy procedures mainly in the inpatient setting. 

Sometimes our patients are poor prep & we need to rescope them the next day.  Because it's often less than 24 hours there's a debate of whether or not we can consent them again.  Additionally we've had patients who went to cath lab or IR the night before and it's also been less than 24 hours for that.  
We tried to look through policies and we can't find anything that addresses this. 

How does your facility handle these situations where they have multiple procedures over their hospital stay that all require informed consent but sedation is occurring with each of these?

I do psych so no procedures but I have been in the position of having multiple nonemergency procedures and each time I was consented for the procedure by the doctor who was doing the procedure. I would imagine that consent for repeated procedures should explain why the procedure was being repeated and of course the risk vs benefits.  A nurse in a procedure room once told me that I should not consent unless I could state exactly what was being done and why.

Hppy

[NickiLaughs, ADN, BSN, RN]

OK thanks.  Most of our patients who just had another procedure the day before are alert and oriented but some nurses say since it hasn't been 24 hours since last dose of sedation, we shouldn't be consenting them.  All I can find is on anesthesias webpage that it isn't recommended. But how can you rule out a GI bleed in a timely manner post cath or choley etc?  
It seems to me if they are oriented/alert and can verbalize the procedure and what it's for, risks/benefits that should be sufficient.

[klone, MSN, RN]

You should be consenting them for EVERY procedure. Just because they consented to an endoscopy yesterday, does not mean they necessarily understand the need for, and consent to, a second endoscopy today.