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Improving the conversation of informed consent in the emergency department

BACKGROUND: The Emergency Department is a quick-moving environment in which rapid identification of illness and prompt treatment is the mainstay of care. Obtaining informed consent from a patient for a high-risk or invasive procedure is required both legally and ethically regardless of the setting. However, informed consent in the Emergency Department is routinely inadequate.
LITERATURE REVIEW: Research thus far has identified several of the barriers to obtaining proper informed consent; a few including language barriers, gaps in intellectual levels, fragmented care of different emergency providers, vulnerability of patients in the ED, and the complexity of the informed consent forms. Investigation into improving the informed consent discussion and patient comprehension has shown promise in implementing patient centered modalities that aid in communication. Such modalities include repeat-back mechanisms, easy-read documents, and implemented multimedia presentations.
PROPOSED PROJECT: In this proposed study, we will focus on a pre-intervention (control) group and an intervention group. The intervention to be implemented will be a paracentesis informed consent video and a provider checklist including procedure, diagnosis/intervention, risks, benefits, and alternatives all to be checked off after being discussed with and repeated back by the patient. Patient understanding will be analyzed using a post-discussion questionnaire completed by all participants. We hypothesize that this intervention will improve overall comprehension of the informed consent discussion regarding the paracentesis procedure.
CONCLUSION: Patient comprehension of the informed consent discussion in the Emergency Department is often lacking in meeting both legal and ethical standards. Reviewing the data for a significant change between the control and intervention group will allow us to determine if enhancing the informed consent discussion to a more patient-centered process will improve patient understanding of all aspects of the informed consent discussion. In the end, this will guarantee ED patients their lawful right to truly informed consent.
SIGNIFICANCE: This informed consent video and checklist will allow for an informed consent process that remains standardized but is more patient focused to improve patient comprehension of the process and protect the rights of all parties involved.

Identiferoai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/26930
Date02 November 2017
CreatorsMatlock, Jamie Elizabeth
Source SetsBoston University
Languageen_US
Detected LanguageEnglish
TypeThesis/Dissertation

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