Informed Consent Quiz
Please select the one best answer to each of the following questions.
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Who Should Obtain Informed Consent for Anesthesia?; Shikha R. Patel, et al., AnesthesiologyNews.com, Article ID=58883, July 8, 2020.
This article focuses on a Pennsylvania case on who can obtain informed consent for the surgical procedure. Serious complications occurred and the family sued because the patient was not adequately informed of the risks involved in the surgery or of the option for a less risky method of treatment. Who obtained consent for this procedure? *
The Pennsylvania Supreme Court ruled in favor of the family, ruling that: *
It is difficult to pinpoint any one moment in medical history that heralded the standard practice of obtaining informed consent prior to the performance of a surgical procedure, but it likely evolved as a result of the malpractice litigation process. *
Informed consent was the salient feature in a 1914 malpractice action which promulgated a battery-based consent framework stating that a surgeon who performs an operation without the patient’s consent commits an assault. *
The concept of informed consent consists of two main components. These include: *
Further legislative actions in Pennsylvania led to the requirement that not only must a physician obtain consent, but that it must be the physician conducting the procedure. This is problematic for anesthesia because: *
The components for informed consent vary from state to state and the anesthesia provider must be aware of the particular requirements in each practice state. *
AANA Informed Consent for Anesthesia Care; Policy and Practice Consideration; updated and copyrighted 2016
The AANA Standards for Nurse Anesthesia Practice require that CRNAs “obtain and document informed consent for the planned anesthetic intervention from the patient or legal guardian, or verify that informed consent has been obtained and documented by a qualified professional”. *
Elements of the anesthesia informed consent process include: *
Disclosure of information includes (at a minimum): *
The anesthesia professional must discuss with the patient the need for possible conversion to general anesthesia in the event of inadequate sedation or regional anesthesia. *
Can You Let Patients Drive Home After Propofol?; Anesthesiology News.com, Article ID=60981.
Traditionally, endoscopy units have required endoscopy patients to find a ride home after procedures. Researchers at the Cleveland Clinic have found that such restrictions maybe too strict. *
The Cleveland Clinic group noted that studies have not addressed the recovery of driving skills in patients receiving propofol (only) sedation. *
In the simulation of driving skills before and after propofol sedation: *
Things to be noted about this study include: *
It was noted that the use of adjunctive medications with longer half-lives could have led to a delay in recovery of driving ability. *
AANA Discharge After Sedation or Anesthesia on the Day of the Procedure: Patient Transportation With or Without A Responsible Adult; Adopted July 2018.
The AANA position on this topic is that “Patients should have a responsible adult who is able to safely transport the patient home or a facility needs to establish policies and procedures if an exception is made.” *
The position further states that “Patients should not be permitted to drive themselves home after the procedure or surgery, particularly if they received sedation or anesthesia.” *
Under the section concerning patient qualification to be an unaccompanied discharge, the algorithm in AANAs position statement: *
The anesthesia professional should be involved in and have the ability to make the decision of whether or not to proceed with the case when the patient will be unaccompanied after discharge. *
Prior to discharge the anesthesia provider must verify that the patient: *
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