[cyd]

I work in a pre/post unit. We get patients ready for pain injections. After the patient is ready, the pain procedure nurse takes them to the pain room and sedate them for the procedure. One of the pre-op nurses forgot to obtain the consent. The pain nurse sedated the patient but discovered the consent has not been signed. Aren't they suppose to check if there is a consent before sedating the patient?
It is the pre-op nurse' job to obtain the consent but who is really responsible in this case? For me, the pre-op nurse did not sedate the patient. Please advise as the pre-op nurses are being blamed for everything. Where does the pain nurses' responsibility lies? Thanks,

[cassioo]

I think it's both. The chart should have been checked before sedation given...is there a preprocedure checklist like a pre-op checklist that is signed for consent obtainted. Is this also something where the MD gets the consent and the nurse is a witness to them signing? Could a family member have given consent? What does your policy say?

[Old_School]

Unfortunately, when we're complacent, we're all pretty much to blame. The pain nurse really should be doing a "Time-out", but she/he probably trusted you guys to hold up you're end. Learn from it and move on, it could really have been a lot worse.

Welcome to the forums cyd.

O_S

[cassioo]

we do the time out which I do find kind of silly for my OR because all we do is c-sections and tubals...if they are in there pregnant they're having a c/s if they had the baby already then it's a tubal.....I know it's the rules if we have a 80 yr old man on the table we'll hopefully figure out we're wrong

[cyd]

We have a checklist for surgery patients where both pre-op and OR nurses sign. So it's going really good with surgery patients, less mess-up. However, because of the high voume of pain injection patients, we don't have a checklist. The assessment sheet serves as the checklist but sometimes things are overlooked. I agree there should be a time-out before they take the patient for sedation and that pain nurses should do that too for their own sake. I think both are responsible but personally, If I am sedating a patient, I would check first if there is a consent. Fortunately, my co-worker found the family member and had her sign. The MD doesn't obtain the consent, it's the pre-op nurses who does it. Thanks for all your input and discussions on this matter. I really appreciate you guys answering my question.
I made my own little checklist to hopefully keep me focus.
Cyd

[cassioo]

does your facility give some incentive for PI ideas of money saving ideas? if they do maybe you could develop that checklist for everyone to use and get some kickback for it also

[cyd]

I don't think they have that for the staff. maybe they have it for the managers as I know in another hospital but this hospital is new and they're always finding ways to save money. Anyway, one of the pain nurses is going to call a meeting between the 2 dept so we can discuss the issue. I heard the managers are considering doing the checklist maybe they're not done making it. all the employees actually attended a mandatory seminar by Lifewings. It's about patient safety, similar to what's being used by Pilots. Pilots have checklist so they don't crash easily. Even the experienced Pilots have to use a checklist. With this background, I can always say 2 heads are better than one. Patient safety is the most important thing.

[kimmiejs]

Here are a couple of links for you to look at... I hope this helps or at least gives you an idea or two.

http://www.fahc.org/Preop/Preop_Cont...ation_Chec.pdf

http://www.childrensheartlink.org/ar..._checklist.pdf

http://www.ssmonline.org/ssmonlineme...uments/108.pdf

http://www.va.gov/vlc/attachments/Su...cklist_VLC.doc