Consent to surgery in a high risk speciality: a prospective audit

A prospective audit was performed to assess how well patients were being co nsented for neurosurgery. Sixty patients with various neurosurgical conditi ons were included in the study. Audit was performed firstly by means of a q uestionnaire to examine the type of information given to patients, and thei r understanding of such information. Secondly the patient's medical notes w ere reviewed to analyse any written evidence by the consenting doctor for t he consenting procedure. 100% of the patients felt that they had been infor med satisfactorily about the nature of their condition and the nature of th e operation. 92% understood the specific risks of their proposed operation. However, only 25% were informed about the general risks of surgery and ana esthesia. Only 33% felt that they were informed fully about alternative tre atment options. 97% of the patients felt that they had reached an informed decision regarding surgery. 67% of the ease notes contained information on the nature and specific risks of the operation, while information on genera l risks of surgery and anaesthesia was documented in only 17% of the case n otes. 33% of the case notes contained no information for the consenting pro cedure, Our audit showed that the patients had a good understanding of the nature and aim of the operation and the specific risks. Areas that require improvement are explaining the general risks of surgery and alternative tre atment. For the consenting doctor, there should be more documentation in th e notes, and there should be mention of the doctor's satisfaction that the patient was deemed to be competent and had made an informed decision.