411 Laparoscopic Cholecystectomy - Is Our Consenting Up to Scratch?

Abstract Aim To audit whether patients in a district general hospital were being adequately consented for laparoscopic cholecystectomy and to standardise the consent process to meet national guidelines. Method Consent forms were audited for inclusion of risks associated with laparoscopic cholecystectomy, as per NHS Websites and the British Benign Upper Gastrointestinal Surgical Society. Subsequently, a standardised, pre-populated, consent form sticker was developed, using the aforementioned guidelines, to ensure adequate detail was included when consenting patients for this procedure. Consent forms were later re-audited during two further collection windows. Results Pre-intervention, of the thirteen risks stated in the guidelines, 0% of patients were consented for all thirteen. Whilst 100% were consented for ‘conversion to open’, ‘injury to the common bile duct’ (CBD) and ‘deep vein thrombosis (DVT) / pulmonary embolism (PE)', only 58% of forms included ‘chronic pain’, and 5%, ‘chronic diarrhoea’. At first follow-up, 20% of consent forms used the pre-populated sticker and therefore consented all risks. This increased to 75% by the final collection window. Post-intervention, every element had over 80% consenting rate, with 11 of the 13 elements either improving or staying the same. Conclusions Use of pre-populated stickers ensured 100% of elements were included when consenting patients for laparoscopic cholecystectomy, which could be important in improving informed decision making for patients preoperatively. However, whilst use of stickers somewhat objectifies this process, it cannot account for differences in individual discussions and explanation of risk between the doctor and patient. Suggestions for future development include increasing the provision of relevant preoperative patient information resources.