The staff nurses are getting our PICC consents signed. They give the patient written info, then the consent is signed and witness by the staff nurse. No one else signs the consent; not the doctor or the inserter. As the person inserting the line, I will go in and explain the procedure along with the risks and benefits to make sure the patient understands the procedure. I feel that the PICC nurse should be explaining and witnessing the form, but was under the impression that the physician who ordered the line would also sign. I was hoping to implement the change when I discovered this issue. What is the standard and are there any legal issues with the consent not being signed by the physician with a PICC insertion?
See the Infusion Nursing Standard of Practice on Informed Consent. The person performing the procedure should be responsible for obtaining the informed consent. This is a process of education and verifiation that the patient understands what is happening. It ends with a signature on a piece of paper but this signature is not the entire process. The person doing the procedure has more knowledge and experience to address all questions and provide explanations. A staff nurse or aide could be the one who witnesses the patient's signature. All that person is doing is saying that indeed the person signing this paper is the right person, and that is all! The staff nurse should never be expected to provide all the patient education and verify that the patient understandas the procedure. How could they since they have never performed the procedure? Physician involvement is not required as they are not involved with the procedure. There are a few states with laws about this process so you must know and follow those laws if present in your state. But for most all, the inserter/operator has the responsibility for obtaining informed consent for every procedure. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
In the State of wisconsin, the only person(s) who can get an informed consent is the Doctor. According to the State law. So when we get an order for a PICC, we do an "education" piece and document that the patient or significant other, whom ever is speaking for the patient agrees to go ahead with the PICC line insertion.
We have the PICC nurse do the consent.
We have been placing bedside PICCs for quite a number of years without a consent. This came about because in the State of Pa. RNs are not permitted to obtain consents. Due to the terminology of medical device and required consent, the medical executive board deemed that PICCs were only a "gloried IV catheter". Much to my dismay. Finally, most recently we have a new CNO who has pushed for the physician ordering the PICC to obtain a consent. I and my PICC nurse have developed a consent specific for just bedside PICC insertions. It is in the process of being approved. Time will tell if the ordering physician will actually obtain the consent seeing they are not the practioner actually performing the procedure.
In SC nurses are not able to obtain informed consent. MDs are not involved with the placement, so would not sign a consent. My hospitals risk management team has deemed PICC placement a form of therapy that goes under the main consent the patient signs and does not need to have an extra "consent". However, education and verification must be documented. I have a great acklnowledgment of consent if you would like a copy. We use an educational acknowledgment that is worded very similarly to an informed consent document. patient or family member signs with the inserter.
Cheryl E. Aldo, RN, BS VA-BC