[Evaluation and improvement of the management of informed consent in the emergency department].
OBJECTIVE
To assess the preoperative management in our emergency surgical service and to improve the quality of the care provided to patients.


METHODS
In order to find the causes of non-compliance, the Ishikawa Fishbone diagram was used and eight assessment criteria were chosen. The first assessment includes 120 patients operated on from January to April 2007. Corrective measures were implemented, which consisted of meetings and conferences with doctors and nurses, insisting on the importance of the informed consent as a legal document which must be signed by patients, and the obligation of giving a copy to patients or relatives. The second assessment includes the period from July to October 2007 (n=120).


RESULTS
We observed a high non-compliance of C1 signing of surgical consent (CRITERION 1: all patients or relatives have to sign the surgical informed consent for the operation to be performed [27.5%]) and C2 giving a copy of the surgical consent (CRITERION 2: all patients or relatives must have received a copy of the surgical informed consent for the Surgery to be performed [72.5%]) and C4 anaesthetic consent copy (CRITERION 4: all patients or relatives must have received a copy of the Anaesthesia informed consent corresponding to the operation performed [90%]). After implementing corrective measures a significant improvement was observed in the compliance of C2 and C4. In C1 there was an improvement without statistical significance.


CONCLUSIONS
The carrying out of an improvement cycle enabled the main objective of this paper to be achieved: to improve the management of informed consent and the quality of the care and information provided to our patients.
del Pozo
P
P
Servicio de Cirugía General y Digestivo, Hospital Morales Meseguer, Murcia, España. pablodelpozo_@hotmail.com
García
J A
JA
Escribano
M
M
Soria
V
V
Campillo-Soto
A
A
Aguayo-Albasini
J L
JL
D004636:Emergency Service, Hospital; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007258:Informed Consent / Q000592:standards* / Q000706:statistics & numerical data*; D012189:Retrospective Studies