title: Surgery for fractured neck of femur - are patients adequately consented?
abstract: BACKGROUND
  Obtaining valid consent is a legal and ethical obligation when performing any procedure in clinical practice. This study was performed to identify the validity and effectiveness of the new consent form and any potential improvement that could be made when taking consent.
  
  
  METHODS
  Case notes of 173 patients undergoing surgery for fractured neck of femur were retrospectively reviewed. Risks and complications of the surgery as listed on the consent form were noted. Sixty-five cases were excluded from the study as they had either old consent forms with no risks recorded or a consent form signed by a consultant due to patient inability to consent. Six of the consent forms could not be located in the notes. This left 102 consent forms to be analysed.
  
  
  RESULTS
  The number of risks documented on each form ranged from 0-8 (mean, 3.92). No risks were recorded in 2 of these 102 forms. Most commonly recorded risks were infection (95.1%), DVT/PE (81.4%) and failure of procedure (59.8%). It was shown that many of the consent forms analysed did not have all the serious or frequently occurring risks recorded on them and that a large proportion of the forms had acronyms or phrases that may mean nothing to the patient. Comparison of documented risks for different hip surgery were made using Fisher's exact test showing no significant difference between the risks recorded on the forms for each type of procedure.
  
  
  CONCLUSIONS
  Although documentation of risks has been improved compared to old consent forms, patients are not necessarily given the most appropriate information to ensure consent is valid. Further refining of consent forms may be necessary to ensure that all major risks are explained and understood by patients and that there is satisfactory recording of this information.
authors.affiliation: University of Manchester, Manchester, UK.
authors.forename: Nick
authors.initials: N
authors.lastname: Probert
authors.forename: Atif A
authors.initials: AA
authors.lastname: Malik
authors.forename: Martyn E
authors.initials: ME
authors.lastname: Lovell
mesh_terms: D032962:Consent Forms / Q000592:standards*; D004739:England; D005265:Femoral Neck Fractures / Q000601:surgery*; D006801:Humans; D007258:Informed Consent / Q000592:standards*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000592:standards; D012307:Risk Factors