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MayVABC
Informed consent vs Assent?

Can assent be used instead of informed consent for all PICC line procedureprocedures? Thank you.

lynncrni
The defintiion of "assent" in

The defintiion of "assent" in the INS SOP Glossary is "agreement by an individual not competenet to give legally valid inmformed consent (eg a child or cognitively impaired person."  You could obtain assent in those situations but it is not acceptable to replace all insertions for every patient with assent instead of informed consent. 

Lynn Hadaway, M.Ed., RN,  CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

MayVABC
Thank you so much. If you

Thank you so much. If you were told by your nurse manager to obtain "Assent", No longer "informed consent " because you're only a PICC RN, not a provider (MD or NP), what would you do?

lynncrni
I ask or investigate why this

I ask or investigate why this is being implemented, what and who is behind this change and why? would immediately check for the written and approved  policy and procedure. If none was written, I would discuss with the nurse manager. Second I would  schedule a meeting with the risk manager to discuss this. Is there a law or rule in your state requiring consent being obtained only by a physician. Does risk management consider the initial consent signed on admission to cover all CVADS? If yes, then why the need for assent?  I would also create a written booklet or some form of instruction and information that I would provide to the patient that included all of the componnets of an informed consent, even though it is not labeled as an informed consent. Read the INS SOP for the list of those components. If your risk management considers the initial consent to include the cvad insertion, then you are still held accountable for the complete education of the patient. In that case, I would add a place for the patient signature to that education piece you have written. I would have the patient sign this education piece, give them a copy and keep a signed copy either in the medical record or in your team files. Informed consetn is an educational process that ends with a signagture on a piece of paper. It is the education that is most important. 

Lynn Hadaway, M.Ed., RN,  CRNI

Lynn Hadaway Associates, Inc.

PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

MayVABC
Thank you so much Lynn! I'm

Thank you so much Lynn! I'm taking your advice. 

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