Improving completeness of surgical informed consent in maternity department of Rwamagana level two teaching hospital

Abstract

BACKGROUND: Obtaining surgical informed consent from patients before intervention is part of integral treatment. It reflects to legal, ethical and quality of care considerations. Rwamagana Hospital is a Level Two Teaching Hospital committed to provide high quality of health services to his clients. However, the accreditation reports revealed a gap in compliance with informed consent standard practices and during baseline data we found SIC incompleteness rate of 75%.

METHODS: A scientific problem-solving approach was used for this pre and post intervention dissertation. The pre-intervention consisted with the retrospective review of 223 SICFs selected systematically from files of patients who were operated in the period of July to September 2021. The results were used as baseline to measure the magnitude of the problem. After root cause analysis, intervention was conducted based on real root cause identified. In post intervention 206 SICFs were used as sample size selected systematically to measure the impact of our intervention. All data were computed and analyzed using Excel application. To evaluate the statistical significance of our intervention, chi-square and unpaired T-tests were utilized

RESULTS: In a period of 12 months of implementation, January to December 2022, the completeness of SIC increased significantly from 25% to 76 % with P value of <0.0121.

CONCLUSION: Without completeness and accuracy of SIC, it gives impression that patients are not informed on their illness and engaged in taking appropriate decisions on the proposed interventions. SIC is an important element in clinical medicine and strongly covered by both national and international standards. Implementation of strategic measures to ensure staff accountability seem to be the effective for good quality of SIC practices.