Who is suppose to time anesthesia consent?

[Nursejones702]

I am a DON at an ASC in Nevada that specializes in pain management. Our pre-op nurses review informed consent for procedure as well as the anesthesia consent (sedation is performed by CRNA's 99.5% of the cases). I have a CRNA that also works with a local HCA facility. She informed me this morning that she was told by HCA manager that the informed consent times (for patient signature, witness signature (the pre-op nurse) as well as the anesthetists signature; must all be the same time. Our nurses here date and time as they review the informed consent with the patient, and then the anesthetist comes in usually a few minutes later and interviews the patient and dates/time and signs. Is there a new regulation for this or is this simply an HCA rule?

[Jeckrn1, ADN, BSN]

Unless the CRNA is there st the time of the patient signature why do the times need to be the same.

[Nursejones702]

That's what I was wondering. I have not been able to find anything that states that this is a regulation... was wondering if anyone else has run into this or if its an HCA thing

[Rose_Queen, BSN, MSN, RN]

I just want to clarify something- the nurses are reviewing the anesthesia consent and having the patient sign it before the CRNA arrives to discuss the plan of care? If that's the case, that's not informed consent. I don't see the times needing to be the exact same time, but the patient should not be signing and therefore no one can witness until after the plan/risks/benefits are discussed. And if they are doing the same with the procedural consent, then that's also not informed consent. Our patient do sign surgical/procedural consents in the physicians' offices prior to day of, and they are accepted with confirmation of the signature belonging to the patient. However, our anesthesia consent must be completed day of.

[FurBabyMom, MSN, RN]

On 9/4/2019 at 8:41 PM, Rose_Queen said:

I just want to clarify something- the nurses are reviewing the anesthesia consent and having the patient sign it before the CRNA arrives to discuss the plan of care? If that's the case, that's not informed consent. I don't see the times needing to be the exact same time, but the patient should not be signing and therefore no one can witness until after the plan/risks/benefits are discussed. And if they are doing the same with the procedural consent, then that's also not informed consent. Our patient do sign surgical/procedural consents in the physicians' offices prior to day of, and they are accepted with confirmation of the signature belonging to the patient. However, our anesthesia consent must be completed day of.

This is mostly our practice. Our one difference is that the anesthesia consent can be from another day, provided that day is the day the patient was seen in our pre-admission testing clinic (anesthesia runs this clinic). If they were not seen in that setting, it has to be from the day of.