HI all, oK what is the consenses on consents for PICC placement. DR or nurse gets the actual consent. We have both here, but we had a mock JAHCO survey and we were told the nurs shouldn't be getting it unless the DR has documented that he has explained the procedure also. They said a nurse getting the consent is a consent, but not an informed one. Does anyone know of any guidlines? Is each state different? Thanks Susan
I have never heard anyone make such a distinction. Did they have evidence to support this statement? There is plenty of information in the nursing literature that the person performing the procedure should be the one to obtain the informed consent. There are laws in some states that make for slight differences. Unless a physician is actually placing PICCs, they would never have the same level of knowledge that a nurse with insertion experience actually has. So I deeply question this person's knowledge on this issue.
Lynn Hadaway, M.Ed., RN, BC, CRNI
www.hadawayassociates.com
Lynn Hadaway, M.Ed., RN, NPD-BC, CRNI
Lynn Hadaway Associates, Inc.
PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Just came back from being summoned by mock surveyors on this. Their statement was that JC only allows for informed consent to be obtained by a physician or advanced practice nurse.
In the past, the opinion that the nurse obtains consent (not informed consent) because they are doing the procedure has been upheld during mock surveys. And I have never been questioned on this by JC. Looks like things may be changing.
They are suggesting that we make sure PICCs are not specifically mentioned in the Informed Consent policy (they are not) and we stop getting consent.
I recently revised our forms and the section that the patient signs is labeled "Patient Authorization", but the form is titled Patient Evaluation/Education/Consent. Guess we will have to rethink and revise again.
Here in California, "informed consent" is to be done by the physician.
Our hospital policy also states that "informed consent" be documented by the physician. This has been an "issue" for years and in fact, we were cited for not having documentation of "informed consent" for a PICC. We tried several different ways such as including it in the PICC insertion order set, but it had to be written in the progress notes.
So, we came up with a "PICC Informed Consent" form that is pre-printed on our physicians' progress notes. All the physician has to do is sign that he's discussed this with the patient, or get a 3-way phone consent like we do for blood transfusions. We were instructed not to proceed with the insertion until that form is signed. At first, is was difficult, but now, people are getting used to it and it is not much of a problem anymore. Also, a large portion of our patients have had a PICC before.
I've attached a copy for you to see. Education of this policy is just as important for the physicians & nurses. Much better understanding and compliance. Hope this helps!
Raquel M. Hoag, RN, BSN, CRNI
PICC Program Coordinator
Washington Hospital
Fremont, CA
Raquel M. Hoag, BSN, RN, PHN, VA-BC