18 / 21
Page 33
November 13-14, 2019 | London, UK
ORTHOPEDICS, OSTEOPOROSIS & TRAUMA
12
th
International Conference on
Journal of Orthopaedics Trauma Surgery and
Related Research
Orthopedics 2019
November 13-14, 2019
J Orthop Trauma Surg Rel Res, Volume 14
Volume: 14 | ISSN: 1897-2276
Audit of consent in hip fracture
Victoria Beynon
Frimley Health Foundation Trust, UK
Background/Aim
: Following Montgomery v Lanarkshire (2015) issues surrounding consent are increasingly subject to
litigation. The GMC is currently updating its guidance, emphasising a patient-centred approach, particularly in relation to peri-
operative risk.
Consent in hip fracture is frequently undertaken by SHO grade doctors who may be unfamiliar with the procedure, potentially
compromising quality of consent.
This audit-cycle’s aim was to assess standard of consent in hip fracture and implement interventions to improve practice.
Study Design
: The audit examined Consent Form 1 for NOF patients admitted over two months. Standards were taken from the
BOA guideline ‘OrthoConsent’. Data included; accurate completion of consent form, grade of health-professional and legibility.
The number of documented peri-operative risks were totalled, categorised into three ranges (0-4), (5-9), (10-16) and allotted a
score (1, 2 or 3 respectively).
Following initial audit, intervention included education from medical and medico-legal professionals and provision of electronic
guidelines. Re-audit followed intervention.
Results
: Baseline assessment comprised 40 consent forms, 22 (55%) completed by SHOs & 18 (45%) by SpRs, with 100%
legibility.
Patient demographics, indication, procedure & anaesthesia were documented in 95% of cases. Consultants confirmed consent
in 7 (17.5%) cases. 2 (5%) provided patient copies. For risk documentation, 3 forms scored 1 (7.5%), 34 scored 2 (85%) & 3
scored 3 (7.5%).
Re-audit was conducted for 45 consent forms; 41 (91.1%) by SHOs & 4 (8.9%) by SpRs. Results were similar for all parameters
bar risk documentation. No forms scored 1, 18 scored 2 (40%), 27 scored 3 (60%). The standard of SHO consent was similar to
SpR.
Conclusions
: Results showed overall improvement in documented peri-operative risk, with those scoring 3 increasing to 60%.
The education intervention also had the unintended effect of improving SHO’s confidence in consenting such that, at re-audit,
only 9% of patients were consented by a registrar.
Biography
Victoria Beynon is a post-foundation junior doctor and an aspiring surgeon. Her research interests include quality improvement for
junior doctors, patient safety and medical education. She is currently a student at St. George’s University of London undertaking a Post
Graduate Certificate in Medical Education and has been made an Honorary Clinical Lecturer at the University. She works closely with
multiple research groups and is currently involved in a number of ongoing projects collaborating with Orthopedic, Urology and General
Surgical teams. She hopes to take up a Core Surgical Training post in the next year to further her career.
Victoria.Beynon1@nhs.net