SURGICAL CONSCIENCE.pptx

Surgical conscience is the permission to perform surgery on a patient that is granted by parents themselves if conscious.

1. SURGICAL CONSCIENCE --- 2 hrs 1

2. Session Outline Objective Surgical conscience Consent Areas affected by surgical conscience Protection of the patient Legal aspects of surgery Criminal responsibilities Common areas of negligence Nursing responsibility

3. Definitions Purposes Circumstances Requiring Consent Essential Elements of Informed Consent Requisites for Validity of Informed Consent Situations that undermine surgical conscience 3

4. Objective At the end of this Session, learners will be able to: Describe Surgical conscience Consent Identify Areas affected by surgical conscience Legal aspects of surgery Common areas of negligence Identify major Nursing responsibility Describe Circumstances Requiring Consent Discuss Situations that undermine surgical conscience Differentiate Essential Elements of Informed Consent Identify Requisites for Validity of Informed Consent

5. INFORMED CONSENT and SURGICAL CONSCIENCE Informed Consent AKA operative permit or surgical consent is permission necessary before surgery obtained from a patient to perform a specific test or procedure . permission obtained from a patient to perform a specific test or procedure

6. INFORMED CONSENT PURPOSES: to ensure that the client understands the nature of the Tx including the potential cxns & disfigurement ( explained by Attending Physician ) to indicate that the client’s decision was made without pressure to protect the client against unauthorized procedure to protect the surgeon & hospital against legal actions by a client who claims that an unauthorized procedure was performed .

7. INFORMED CONSENT AKA OPERATIVE PERMIT or SURGICAL CONSENT necessary before non emergent surgery can be performed permission obtained from a patient to perform a specific test or procedure PURPOSES: to ensure that the client understands the nature of the Tx including the potential cxns & disfigurement ( explained by AMD ) to indicate that the client’s decision was made without pressure to protect the client against unauthorized procedure to protect the surgeon & hospital against legal actions by a client who claims that an unauthorized procedure was performed.

8. CIRCUMSTANCES REQUIRING A PERMIT : any surgical procedure where scalpel, scissors, or sutures may be used any invasive procedure such as surgical incision, a biopsy, a cystoscopy, or paracentesis. a nonsurgical procedure, such as an arteriography, that carries more than slight risk to the patient procedures involving radiation Radiologic procedures, particularly if a contrast material is required. procedures requiring sedation and/or anesthesia General anesthesia, local infiltration and regional block. procedures requiring e ntrance into body cavity .

9. INFORMED CONSENT CIRCUMSTANCES REQUIRING A PERMIT: any surgical procedure where scalpel, scissors, or sutures may be used any invasive procedure such as surgical incision, a biopsy, a cystoscopy, or paracentesis a nonsurgical procedure, such as an arteriography, that carries more than slight risk to the patient procedures involving radiation procedures requiring sedation and/or anesthesia

10. ESSENTIAL ELEMENTS OF INFORMED CONSENT The diagnosis and explanation of the condition. explanation of procedure to be done and its risks & the consequences description of the benefits to be expected. alternative treatment or procedure. t he prognosis, if the recommended care, procedure is refused . an offer to answer questions about procedure. instructions that the patient can withdraw consent. a statement informing the patient if the protocol differs from customary procedure. 10

11. REQUISITES FOR VALIDITY OF INFORMED CONSENT Written permission is best and legally accepted. Signature is obtained with the client’s complete understanding of what to occur. adult patients sign their own operative permit. obtained before sedation. For minors, parents or someone standing in their behalf, gives the consent . Note: for a married emancipated minor parental consent is not needed anymore, spouse is accepted .

12. REQUISITES FOR VALIDITY ……… For mentally ill and unconscious patient, consent must be taken from the parents or legal guardian. If the patient is unable to write, an “X” mark is accepted if there is a witness to his mark. Secured without pressure or duress and threat. A witness is desirable –nurse, physician or authorized persons.

13. REQUISITES FOR VALIDITY …….. When an emergency situation exists, no consent is necessary because inaction at such time may cause greater injury. the surgeon may have to operate without consent, others, however, makes every effort to obtain consent by telephone, or fax. permission via telephone/cellphone or telefax is acceptable but must be signed within 24 hrs . Implied consent ?

14. REQUISITES FOR VALIDITY ……. Each nurse must be familiar with agency policies and state laws regarding surgical consent forms. The nurse is responsible for ensuring that all necessary parties have signed the consent form and that it is in the client’s chart before the client goes to OR.

15. INFORMED CONSENT REQUISITES FOR VALIDITY OF INFORMED CONSENT written permission is best and is legally acceptable signature is obtained with the client’s complete understanding of what is to occur adults sign their own operative permit obtained before sedation secured without pressure or duress a witness is desirable – nurse physicians or authorized persons in an emergency, permission via telephone or telefax is acceptable for minor (below 18), unconscious, psychologically incapacitated, permission is required from responsible family member (parent/legal guardian)

16. INFORMED CONSENT INFORMED CONSENT SHOULD CONTAIN THE FOLLOWING: explanation of procedure and its risks description of benefits and its alternatives an offer to answer questions about procedure instructions that the patient may withdraw consent a statement informing the patient if the protocol differs from customary procedure