406 Review of Consenting Practice at the Tertiary Centre for Emergency Inguinal Hernia Repair
B B Karki, A Nadjarpour, S Akram, S Katuwal- Surgery
Abstract
Aim
To compare standardised consenting practice for Emergency Inguinal Hernia Repair amongst various grades in the General Surgery department at the Tertiary Centre. To ensure improvement in the consenting practice and documentation of the risks associated with the procedure.
Method
A proforma was devised which included ten recognized complications following Emergency Inguinal Hernia Repair after a review of literature, BHS Guidelines, and GIRFT which were then cross-referenced with the consent forms of 20 patients: retrospectively & prospectively for the first & second cycles respectively between the period of August 2021 to July 2022.
Results
Out of 11/20 forms completed by junior doctors in the first cycle: FY2(3/11), CT (8/11), documented 6/10 and 6.75/10 risks resp. Speciality Registrar 8/20 (40%) & Consultants (1/20) both documented 6/10 risks which concluded on the wide variation in risk documentation practice. Following to this, consenting workshops were carried out including peer-to-peer teaching & development of the consenting posters. Furthermore, a re-audited result showed a satisfactory increase in risk documentation by 19%, 10%, and 25% among Junior Doctors, Registrars and Consultants along with >10% increase in the documentation of post-op complications like chronic pain, and orchidectomy.
Conclusions
There was a marked improvement in the consenting practice achieved via workshops, posters and peer-to-peer teaching sessions. Further review will be carried out for introducing procedure-specific consent forms in the Emergency setting which will not only act as a source of information for the patient but also a prompt for the doctors to discuss the risks.