What is If you work in a hospital, you have likely seen informed consent paperwork. Typically, a patient must sign a document indicating that they are giving informed consent before any type of invasive procedure, surgery, or risky medication administration. Legally, patients can give verbal or written consent, but written consent is preferred. For some healthcare providers, getting informed consent is just something to check off a very long to-do list. However, it is important to remember that informed consent in nursing is more than just getting a signature or a verbal agreement from a patient.
Recommended course: Communication in Health Care, 2nd Edition
What is informed consent in nursing?
Informed consent in nursing is a way to ensure that a patient understands and agrees to their healthcare plan. For a patient to give informed consent, they must have at least a basic understanding of what will happen to them, why they need a procedure or medication, expected side effects and complications, and alternative options.
In addition, a patient can only give informed consent if they are over the age of 18, are not under the influence of mind-altering drugs or medications and are giving consent freely. Whenever possible, the patient must also be given enough time to ask questions, think about the benefits and risks, and perform their own research.
In an emergency where timely treatment is required to avoid severe injury or death, providers may proceed with treatment without obtaining informed consent. Rather than just being told what they should do, patients have a right to understand the risks, benefits, costs, and alternative options for all procedures.
Assessing understanding
Before verbal or written consent can be given, a patient has to understand what they are agreeing to. Assessing understanding can be difficult, because patients are often hesitant to ask questions, even when they remain confused.
Since informed consent requires understanding, the nurse has a responsibility to ensure that the patient knows what they are agreeing to. One of the best ways to assess understanding is by using the teach-back method.
To use the teach-back method, the patient should start by ensuring that the patient is ready to learn, that there will be no distractions, and that both the patient and nurse have plenty of time to devote to teaching and/or learning.
After it has been determined that there is plenty of time and that all parties are prepared to focus on education, the nurse can begin to teach using explanation, demonstration, and written materials. When teaching has been completed, the patient should be allowed to ask questions.
When the patient has had a chance to ask clarifying questions, the nurse can ask the patient to reverse the roles of teacher and student. A patient who has a good understanding should be able to teach the basics back to the nurse, and the teach-back session is a good opportunity for the nurse to identify errors or gaps in understanding.
Recommended course: Educating Patients: Creating Teaching Moments in Practice
Barriers to professional-patient communication
Research shows that nurses frequently overestimate their patient’s levels of knowledge and understanding. This overestimation has several causes:
- Patients feel too overwhelmed to ask questions.
- Patients are embarrassed to ask questions.
- Nurses don’t have enough time for adequate teaching.
- Nurses don’t have concrete ways of assessing understanding.
- Language barriers between nurses and patients.
- Lack of educational materials
Benefits of good patient teaching
Patients have the right to be educated and gain a solid understanding of their treatment plan. In addition, adequate understanding and good health literacy helps to:
- Reduce hospitalizations
- Decrease hospital readmissions
- Improve medication management
- Increase compliance with routine screenings
- Reduce health complications
Improving communication
While there are many barriers to good patient education, there are also many ways for nurses to improve communication and patient understanding.
- Help the patient feel safe asking questions. Patients often feel embarrassed when they admit they don’t understand what they have just been told. Nurses can overcome this barrier by building a good rapport with their patients, treating all patients with respect, and remaining patient and understanding while teaching.
- Choose a good time to educate. Before you provide patient education, find a time that works well for the patient. Choose a time when both you and the patient can focus on learning without any distractions. Waiting to educate a patient immediately before discharge or right before a procedure will make it more difficult for the patient to focus.
- Use models, drawings, and real-life demonstrations. It can be difficult for a patient to visualize their internal anatomy or understand complex mechanical devices. Using three-dimensional models or pictures can make it easier.
- Repeat the information several times. Studies show that information should be repeated at spread-out intervals to increase retention. Teaching the same information several times over several days is ideal.
- Use several teaching methods. All people learn in different ways. Patients may be visual, auditory, reader, or kinesthetic learners. Using different strategies increases the chances of a patient understanding a nurse’s teaching.
