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Tim
Informed Consent

Does your facility require Informed Consent for PICC insertion?  If so, who obtains the Informed Consent (not the signature on the page but rather the agreement of the patient after providing the patient with the required information and answering questions)?  What state are you in?

 Thanks in advance,

 Tim

T. Nauman RN, CRNI  IV

T. Nauman RN, CRNI  IV Educator SHMC Eugene, OR

This is a very good question.  We(the PICC nurse)usually obtains the consent after explaining the procedure.  At times, the patient's nurse will obtain the written consent.  We always do a "time out" before starting the procedure=checking patient's name & birthdate, and getting verbal consent...in addition to written consent.  However, we do this for our own protection and satisfaction since our physician group has taken PICC placement off the list of invasive procedures...which means in our hospital that we don't have to get a written consent.  The docs have done this for their own convenience(don't get me started!), but we still feel it's necessary.

 

T. Nauman RN, CRNI

Gwen Irwin
Currently, we have a written

Currently, we have a written consent.  We are in the process of revising it OR deleting it!  We are revising it to say that the nurse has explained the procedure and the risks, instead of the "physician has explained...."

We are consulting with our legal department and a group of physicians to see if it will continue to be necessary.  We may go to verbal consent and document that we did the teaching and "verbal consent was obtained from ____".

I will try to update this when we have answers to our own questions.

Gwen Irwin

Austin, Texas

Wendy Erickson RN
We use a specific consent
We use a specific consent form for PICC placement, we do the explanation and obtain the informed consent and sign the form along with the patient.  Our Legal department OK'd this since we are the ones doing the procedure.  If the patient is unable to give consent, we contact the person designated to give consent and get their permission.  This is Wisconsin, but may not be consistent acrorss the state.

Wendy Erickson RN
Eau Claire WI

fizerjk
We do our own consets for
We do our own consets for adult and pediatric patients. Those patients who are unable to give informed consent and or lack a legal and reponsible party to consent for them are consented by the physician (medical necessity).

Jeffery Fizer RN, BSN

Great question! In

Great question! In California, the state requires that physician gives the "informed consent" and has to document it. This is an on-going struggle in terms of compliance from our physicians. We were cited for this a few years back. As a result, we have developed a physician's form to go in their progress notes that is the "PICC Informed Consent". Basically spells out in detail the risks and benefits of a PICC insertion. There is also a box for "3-way phone consent". This is how they do blood transfusions as well. 

It has been 2 years and slowly, the doctors are now getting used to signing this.

I'm wondering how other hospitals in California do this?

Thanks,

Raquel M. Hoag, RN, BSN, CRNI

Fremont, Californa 

 

Raquel M. Hoag, BSN, RN, PHN, VA-BC

Patti Jo Carruth
Hi Raquel! I've been

Hi Raquel! I've been wondering this too as I'm used to having  "nurse" consent for a "nursing" procedure of putting the PICC line in....currently I'm seeing Informed consents with "NO" physician signature anywhere and witnessed by only a nurse....is this a California Law, and if so where can I find it???? thanks pjc

lynncrni
Patti Jo, a law in

Patti Jo, a law in California would not apply here in GA. There is an informed consent law in GA but I don't have a copy of it. I came about many years ago, when a legislator had a delayed reaction to something on his way home from a procedure. This was back in the 1980's. Your risk management should know about this.

A signed piece of paper is only a very small component of the entire informed consent process, although we sometimes think of it as the all-encompassing act of informed consent. The person performing the procedure should be the one to educate the patient about the procedure, risks, benefits and alternatives. Without all of this education, there is not informed consent to be obtained, regardless of whose name is on the form.  

Lynn Hadaway, M.Ed., RN, BC, CRNI

www.hadawayassociates.com

Lynn Hadaway, M.Ed., RN, BC, CRNI

Lynn Hadaway Associates, Inc.

126 Main Street, PO Box 10

Milner, GA 30257

Website http://www.hadawayassociates.com

Office Phone 770-358-7861

Gwen Irwin
After consulting our legal

After consulting our legal department and physicians, we will not be doing written consents for adults.  We have 5 adult hospitals and 1 pediatric hospital.  At this time, the pediatric community will continue with written consents.

Tim, what do you do?

Gwen Irwin

Austin, Texas

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