P98 Consent and complications in bronchoscopy: a trainee-led, region-wide evaluation. (11th November 2022)

• Record Type: Journal Article
• Authors: Pippard, B; Wilkinson, D; Ong, W; Carlin, HJ; Sobala, R; Shakir, S; Fretwell, T; Carling, M; Kibbler, J; Holland, C
• Is Part Of: Thorax. Volume 77(2022)Supplement 1
• Page Start: A133
• Page End: A134
• Publication Date: 2022-11-11
• Subjects: Chest -- Diseases -- Periodicals; Thorax; Chest -- Diseases; Periodicals; Periodicals; 617.54
• DOI: 10.1136/thorax-2022-BTSabstracts.234
• Languages: English
• ISSNs: 0040-6376

Abstract

Abstract : Introduction: Flexible bronchoscopy (FB) remains an important tool in the assessment of respiratory disease that is frequently performed within the outpatient setting. While guidelines exist concerning safety standards in FB, 1 individual practice is known to vary, which may extend to patient consent and discussion of potential complications. In this study, we aimed to evaluate consent procedures for patients undergoing FB within one healthcare region, including how this relates to actual complications observed. Methods: A retrospective review of patients undergoing FB between 1stApril 2021 and 30th September 2021 was performed across five hospital sites in the North East of England. Medical records, including patient consent forms and bronchoscopy reports, were examined using a structured proforma (guided by existing BTS standards 1 ). Specific areas of consideration included: the person obtaining consent; whether the consent form was pre-populated; the type of complication discussed; and, if any complications were observed. Results: In total, 312 patients were included for analysis across the five hospital sites. Medical records were either incomplete or not available for a further 33 patients. Two hospital sites (A and B) predominantly used pre-populated consent forms; the remaining three sites (C, D and E) used free-text consent forms. Most consent forms (208/312, 67%) were completed by consultants, with the majority (242/312, 78%) occurring on the day of the procedure. All sites differed in the extent of complications patients were consented for (see figure 1 ). Hypoxia (58/312, 19%) and bleeding (55/312, 18%) were the two most frequently observed complications, but were variably included in the consent process. One death occurred as a direct consequence of bronchoscopy, though was not stated in the consent form for this patient. Conclusions: There is wide variation regarding consent procedures for FB, even within a single healthcare region. This includes the type of consent form used, the timing of consent relative to the procedure, and the specific complications (and rates of complication) consented for. Use of a standardised pre-populated consent form, which could be adopted at a regional – or national – level, would help to reduce this variability in practice. Reference: Du Rand IA et al. Thorax, 2013;68 :i1-i44. Please refer to page A214 for declarations of interest related to this abstract.