G333 Obtaining consent for pregnancy testing in patients undergoing surgical, radiological and anaesthetic procedures

Abstract

Aims To establish if National Institute for Health and Care Excellence (NICE), Royal College of Surgeons (RCS) and Royal College of Paediatrics and Child Health (RCPCH) standards are being met for pre-procedure pregnancy testing in under 16s. Methods A pro-forma was created based on the RCPCH guidelines for pre-procedure pregnancy testing in under 16s. This included: establishing whether the child was Fraser/Gillick competent; obtaining consent; performing the pregnancy test and delivering the result. Inclusion criteria: patients aged 12–16 years old attending for a radiological procedure, elective or emergency surgery or abdominal pain between 01/01/2016 and 30/06/2016. Results 48 patients met the criteria with a mean age of 14 years. The commonest presentation was abdominal pain with 88% of cases presenting with this. 81% of all patients were asked whether they had started their periods or not (as stipulated in the guidelines) and of those asked 82% had. The guideline recommends that competence should then be assessed. Assessment of competence was documented in 52% of cases. Consent should be sought before performing a pregnancy test in all patients. Pregnancy testing was performed in only 46% of patients and only 36% of those that were tested had consent for the test documented in the notes. Conclusions In the department where the audit was performed the standards are not currently being met for pregnancy testing in patients aged 12 and 16 presenting with abdominal pain or for surgical, anaesthetic and radiological procedures. The RCS 2015 standards recommend that all departments should have a policy around ascertaining pregnancy status. This does not currently exist in the department in which the audit was performed. Following this audit and a presentation of the results to all specialities involved, a policy is now being developed. In order to aid implementation of the policy, education on assessing competence and obtaining consent has been given to all stakeholders. A leaflet on pregnancy testing has been created to be given to patients prior to procedures or when presenting with abdominal pain with the aim of aiding clinicians in consenting for and performing pregnancy tests.