EP.WE.628The Challenges of Consent and COVID-19: Analysis of Documentation of Risk of Hospital Acquired COVID-19 Infection in a District General Hospital

Abstract

AimsThe COVID-19 pandemic poses a new material risk to hospital admissions and we must modify consenting practice accordingly. This study assessed documentation of the risk of COVID-19 infection and associated morbidity in consenting practice for patients undergoing general surgical procedures under general anaesthesia at a district general hospital.MethodsThis is was a two-cycle study design. An initial retrospective case-note analysis of 41 inpatient consent forms and operation notes during April 2020 was performed. Data were gathered on points from the Royal College of Surgeons (RCS) guidance, including documentation of risk of COVID-19 infection. Recommendations were then offered including a teaching session from the departmental lead into the importance of documenting risk of COVID-19 infection. A prospective case-note analysis of 45 inpatient consent forms and operation notes during November to December 2020 was then performed.ResultsIn cycle one, of 41 cases, 39% (16) had risk of chest infection documented. Of these, 16 (63%) specified COVID-19 in risk documentation. Morbidity related to COVID-19 was documented in 4 (25%) of these 16 cases. Following interventions, of 45 cases, 93% had risk of COVID-19 infection and associated morbidity documented (χ2 = 89.3646, p < 0.00001 significant at p < 0.05).ConclusionWe initially identified a deviation from RCS consent guidance. The second cycle results show a significant improvement in consenting practice for the risk of contracting COVID-19 for inpatient surgical procedures. We aim to further refine our recommendations to ensure that this material risk is communicated to patients during the initial consent process.