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Child's Nervous System

, Volume 35, Issue 12, pp 2363–2369 | Cite as

Consent in paediatric neurosurgery: adequacy of documentation and parental perspectives

  • Adikarige H. D. Silva
  • Haren Wijesinghe
  • Nilesh Mundil
  • William Lo
  • A. Richard Walsh
  • Guirish A. Solanki
  • Desiderio RodriguesEmail author
Original Article
  • 63 Downloads

Abstract

Introduction

Consenting paediatric patients for surgical procedures remains inherently unique in that it is underpinned by principles such as parental responsibility, assessment of the child’s capacity to consent, and adherence to national/legal guidelines. Quality record keeping is an important objective evidence to demonstrate the highest standards of medical care provided to our patients. The consent form is a crucial medical record encapsulating the attainment of informed consent from a parent/guardian for performing a procedure on their child. We aimed to prospectively evaluate the consenting process in our department to assess adequacy of documentation and parental perspectives.

Methods

A prospective study using qualitative descriptive design was conducted with parents of 50 children requiring neurosurgical procedures over a 3-month period.

Results

All patients understood the primary diagnosis and type of surgery. Procedure-specific risks were understood by 98% and 84% could remember the mentioning of general risks of surgery. Only a minority of parents (24%) could recollect that alternative options of management including no treatment were discussed. In cases where relevant, laterality was only documented in 56% of consent forms. All patients felt that an informed decision regarding consent to surgery was made. However, 12% suggested areas where further improvement could be made in the timing of consent and the way information could be better provided.

Discussion

Consent is more than a signature on a form. It provides objective evidence of a shared decision-making process between the surgeon, patient, and their parent/guardian. Our initial study highlights multiple areas for improvement.

Keywords

Consent Paediatric Capacity 

Notes

Compliance with ethical standards

The hospital internal audit review department sanctioned our study.

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Supplementary material

381_2019_4285_MOESM1_ESM.pdf (460 kb)
ESM 1 (PDF 459 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of NeurosurgeryBirmingham Children’s HospitalBirminghamUK

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