I know this has been discussed, but I am seeing several things. It appears, that some facilities feel that MDs only should get PICC consents signed vs the PICC RN. Also, there is a tendency to use a general form that has a few of the risks associated with Percutaneous CVC and Tunnelled CVCS on the consent with an indication to refer to a list of other risks in small print on the back of the form. It is my opinion that risks should be specific to the type of line, and visible on the page the patient signs, and following the explanation of risks, benefits, and alternatives.
Any feedback on Doctors explaining the risks, and getting these signed. Often they do not know the risks, especially if they have not inserted them or even watched a placement. As the person inserting, it concerns me about the specificity of the explanation, and the understanding that the patient has, going into this procedure. I fear that this is not protective of us, should there be an injury, ie, "no one mentioned that ....... could happen"
Also, some facilities are not using consents at all, depending on the permit to treat. How does that inform the patient of the reality of an invasive procedure.
In reviewing ~700 cases over the past 23 years, I have never seen a single case where the informed consent page was a factor in the case. Informed consent is an education process that ends with a signature on a piece of paper. Some state laws and risk management may require the prescribing physician to obtain that signature and that means they should do the education, but it does not mean that you cannot and should not assess patient for their knowledge and any additional question. Inserter can and should do the education as well as the person obtaining the signature.
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