Anaesthetic Consent: Information leaflets

and patient recollection – could we be doing more?

The Problem

• The Covid Pandemic has resulted in fewer elective patients physically attending pre-op clinic to discuss their anaesthetic options; low-risk patients are assessed over the phone.

• Conversations with patients highlighted many weren’t retaining key information on the risks and benefits of their anaesthetic.

Aims

• Establish the discrepancies between what patients were consented for and their recollection of this – were information leaflets helping?

• Improve patient engagement in the process of consent.

RCOA Standard

“Those undergoing elective surgery should be provided with information before admission, preferably at pre-assessment or at the time of booking, but the duty remains on the anaesthetist to ensure that the information is understood.” (2017)

Method – Plan & Do

• A simple questionnaire was designed and 30 patients approached on the day of their elective surgery and asked to complete it.

• Information was gathered on whether they could recall the anaesthetic they were having, the risks and benefits of this and whether they had found the posted information leaflet useful (2022).

• A mix of quantitative and qualitative data was obtained, including information on the grade of anaesthetist gaining consent and the type of surgery being performed.

• This was undertaken over a 6 week period and the results charted and analysed.

Discussion - Study & Act

• The data was presented and discussed at the departmental QI meeting.

• This highlighted an issue with patient engagement with the process of anaesthetic consent, contributing to a lack of awareness of the risks.

• An information poster was designed and displayed in patient-facing areas with the help of Pre-Operative Clinic and Day Case Unit teams.

Conclusions & Next steps

• Although most patients recalled the type of anaesthetic they were receiving, many (43%) retained no risks of it whatsoever.

• The majority of patients are reading their information leaflets but many don’t feel that the volume of information was relevant to them and that these decisions were in the hands of their anaesthetist

• This has highlighted an issue with patient engagement with anaesthetic consent and a lack of awareness of the risks

• It is hoped that the posters will engage patients and encourage them to take an active interest in their anaesthetic.

• Potential for further data collection within anaesthesia, as well as involvement of the rest of surgical division in gauging patient engagement in consent.

Bibliography

1. AAGBI: Consent for anaesthesia 2017. 2017. doi:10.1111/anae.13762/full. https://www.aagbi.org/sites/default/files/AAGBI_Consent_for_anaesthesia_20 17_0.pdf.

2. Patient information leaflets and video resources | The Royal College of Anaesthetists. rcoaacuk. https://rcoa.ac.uk/patient-information/patientinformation-resources/patient-information-leaflets-video-resources.

With thanks to…

Dr Rebecca Barker and the Pre-operative and Day Case Unit teams at Sherwood Forest Hospital NHS Trust