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B122 Up the hill or down the hill? Challenges in documenting consent for regional anaesthesia in a quaternary orthopaedic centre
  1. P Chater-Lea,
  2. S Galitzine,
  3. T Jones,
  4. K Wilson and
  5. J Matthews
  1. Nuffield Orthopaedic Centre, Oxford University Hospitals Fundation Trust, Oxford, UK


Background and Aims Informed consent is a vital component of patient care, and should include the benefits of the procedure, as well as risks, complications and alternatives.1 As per AAGBI2 and RAUK3 standards, consent documentation for peripheral nerve blockade (PNB) is a professional and legal obligation. In response to variable documentation quality in our centre, Standardised consent labels (nicknamed the ‘Oxford sticky label’) were introduced in 2005, with regular audit and revisions, most recently May 2019.

Methods This was the third prospective re-audit of consent documentation for PNB since the 2019 standardised label revision. On each occasion, anaesthetic charts of ~50 consecutive patients undergoing PNB were reviewed. This time the audit was not advertised to clinicians to avoid biased performance. Overall performance of documentation was assessed; use of labels was considered gold standard.

Results Standardised labels as opposed to handwritten documentation were used in 17% of cases, declining from 28% previously. Use of labels was associated with a higher documentation quality of key information points (87% versus 23% without labels). However, the decline in label use was associated with an overall fall in frequency of key consent points being documented, to 34% from 47% previously.Overall performance has, however, improved compared with pre-label introduction.

Conclusions Appropriate documentation of valid consent is vital. Standardised labels have consistently improved this, however there is some way to go in achieving gold standard (>95%). Time pressures and lack of availability of labels often hinder comprehensive documentation, however the impending advent of electronic anaesthetic records should counter some of these issues.

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