Presentations 2020: OMFS

408 - Consent for excisional biopsies of skin lesions - a retrospective audit of Form 1 All-Wales consent forms.

TP Cole V Kamisetty
Presented by: Thomas Cole
Glan Clwyd Hospital

Introduction Consent for all procedures carried out in the outpatient department is recorded using the Form 1 All-Wales consent forms. Since 2017, a specific template for excisional biopsies of skin lesions, believed to be neoplasms, has featured on our trust intranet. The aim of this audit was to ascertain if the aforementioned form was being completed satisfactorily and to ensure the consent process was carried out sufficiently. Method Clinical notes of 50 patients, following excisional biopsies of skin lesions, were accessed. They were audited using agreed standards outlined in a pro-forma adapted from the 2014 consent audit. The results were compared to the previous audit and to the gold standard of 100% compliance. Results The most commonly discussed risks were infection, bleeding and swelling, however no single risk was consistently noted on all consent forms. Discussions of the planned procedures, patient concerns, and alternatives were recorded on 56%, 52% and 48% of forms, respectively. Details of the healthcare professional recording consent were usually completed, however registration numbers were given less often and contact details were rarely listed. Of those requiring confirmation of consent, 41% were not confirmed. From the 24 sections of the pro-forma, 3 achieved the gold standard; 6 failed to reach the standard previously set by the audit and 15 achieved the same standard or higher. Conclusion Consent forms were generally of a standard similar to or better than the 2014 audit, nonetheless, the majority of the consent process can still be improved to achieve the gold standard of 100%. In 12% of cases, the standard fell short of that achieved in the 2014 audit. Specific areas to focus on are discussing the procedure with the patients, discussing any concerns, and alternative treatment options. The incidence of consent forms with no confirmation of consent must be reduced. A re-audit will take place in 6 months.
Consent Statement: There are no details on individual patients reported within the abstract.

Poster