Surgeon is solely responsible for obtaining informed consent—nurses cannot obtain informed consent on behalf of an HCP performing a procedure, but they may witness the consent for the purpose of validating that Pt/guardian was observed signing/giving consent.

If any information needs to be edited, added, or deleted from original consent, a new consent must be created and reflected in PARQ.

Components of an Informed Consent

Consent should never contain abbreviations; all words spelled out.

• Facility where surgery being performed.
• Name of surgery (procedure^*) with correct side (if applicable).
• Name of surgeon(s) performing surgery.
• Reason surgery will benefit^* Pt.
• All alternative^* options to surgery.
• Potential risks^* of surgery including if surgery not performed.
• All Pt questions^* about surgery answered
• Consent for anesthesia and blood products (some facilities may use separate form).

^* PARQ Documentation

PARQ is a thorough conversation between Pt and Surgeon performing surgery—It must either be part of consent form or documented in Pt’s medical record prior to signing consent; it consists of:

• P—Procedure: Explanation of surgery and benefits of surgery.
• A—Alternatives: Alternatives to surgery including not having surgery.
• R—Risks: Potential risks of surgery including not having surgery.
• Q—Questions: All Pt’s questions pertaining to surgery answered.

Inability to Consent

• Pts Who Are Cognitively Impaired: A medical power of attorney (MPA) must be established for consent purposes.
• Pts Who Are Cognitively Aware but Unable to Physically Sign: An “X” is acceptable but requires two witnesses.
• Deaf Pt or One Who Only Speaks Another Language: Certified medical interpreter must be used—family members cannot be used for medical interpretation—use of an anonymous interpreter avoids bias that may occur when family members interpret.
• Emergency Situations (no MPA or next of kin available in person or by phone): Pt’s verbal consent is acceptable, but written consent should be obtained ASAP following surgery. If Pt incapable of giving consent, two providers must document need for surgery.
• Minors: Need consent from a legal guardian. Local/state law may define age of consent as low as 15 yrs—refer to facility policy.
• Other Situations: May require special permits done well before surgery (e.g., sterilization) where Pt must sign a unique consent 4 to 6 weeks prior to surgery (requirement may vary between states).