971 Audit of Consent Documentation for Emergency Hand Surgery in the Ambulatory Procedure Unit

Aim

To audit the handwritten consent forms for emergency hand surgery in the unit.

Method

The notes and consent forms from a selection of 8 days were analysed (total 25). Our audit standards focused on the consenter and the completion of sections on the consent form. There are no published standards for hand surgery complications, therefore a consensus from the general consultant body was used.

Results

80% of our patients were male with a mean age of 48 (range 20 – 71). 60% were tendon repairs, 20% debridement, 20% digital nerve repairs, 12% nail-bed repairs, 12% excision of lesion, 8% terminalisation, 8% incision and drainage, 8% manipulation under anaesthesia, 4% carpal tunnel decompression and 4% plating of fracture.

68% of the consenting clinicians were Registrars, 16% Senior House Officers and 8% Consultants (8% illegible). 92% of the consenters performed the procedure. All the consenters signed and dated their signature and were trained in consenting. 88% documented their job title.

100% of clinicians used the correct consent form, documented the proposed procedure, site and risks. 92% completed the ‘intended benefits’ section, 96% wrote the procedure name in full and 88% placed a label on every page.

Every clinician documented bleeding and infection as a risk factor. 92% documented complex regional pain syndrome, 68% stiffness, 48% wound dehiscence, 40% delayed healing, 84% scarring, 36% injury to surrounding structures and 56% further procedures.

Conclusions

The quality of hand-written consent forms is user dependent. A pre-filled consent form and discussion in clinical governance is proposed to increase compliance.