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OC-003 Nurse vs doctor consent within endoscopy: are they equal?
  1. J Waloszkova,
  2. F Avey,
  3. A Leahy
  1. Endoscopy Unit, West Hertfordshire Hospitals NHS Trust, Watford, UK

Abstract

Introduction This study compared the effectiveness of nurse led consent vs doctor led consent for patients undergoing day case diagnostic endoscopy. There have been no previous studies that have directly compared nurse to doctor consent within endoscopy. Ten years ago, it was suggested that consent at that time was mostly a doctor's task, but it might be beneficial to involve a nurse in the consent process.1 There is a need to determine whether nurse consent is as effective as doctor consent, as nurse consent could lead to a more streamlined patient service, improve unit efficiency and increase job satisfaction.

Methods The study assessed patient knowledge, understanding and experience of an endoscopic procedure after being consented by either a nurse or a doctor. Patients who had a diagnostic gastroscopy were prospectively studied. The following groups of patients were excluded: non-english speaking patients; patients with previous experience of the procedure; sedated patients as the sedation might have impaired mental recall: and inpatients because of possible confounding comorbidity. An abbreviated previously validated consent questionnaire was used (the QuIC questionnaire),2 with specific reference to the overall understanding of the test, risk/benefits and alternatives. The significance of observed differences were statistically assessed by the Student's t-test.

Results Patients were consented by either their named nurse or the doctor carrying out the procedure. All nurses trained in consent participated in this study, 10 staff nurses and two sisters. Doctors who participated in this study were four consultant gastroenterologists, three gastroenterology registrars, two consultant surgeons and one elderly care consultant. Questionnaires were completed for 65 nurse consent and 47 doctor consents. Patients had a better understanding of the alternatives to having the procedure when consented by a nurse (p<0.03). Patients understood the risks, discomfort, benefits and the overall procedure equally whether consented by a nurse or doctor.

Conclusion This study has shown that nurse consent in our unit was more thorough than doctor consent. Patients who were consented by a nurse showed greater understanding of the alternative options to having the endoscopy. There was equal understanding of the risks, discomfort, benefits and overall procedure whether consented by a nurse or a doctor. Based on these results, endoscopy units should consider adopting nurse led consent into their daily working practice.

Competing interests None declared.

Reference 1. Joffe S, Cook EF, Cleary EF, et al. Quality of informed consent: a new measure of understanding among research subjects. J Natl Cancer Inst 2001; 93:193–47.

2. McParland J, Scott PA, Arndt M, et al. Autonomy and clinical practice 3: issues of patient consent. Br J Nurs 2000;9:660–5.

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