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关于书面同意的时间的伦理问题
The Journal of clinical ethics
|November 14, 2024
概括
大多数手术同意书都是在手术当天在急忙的术前环境中签署的,这可能会损害知情同意的质量. 语言差异,特别是西班牙语说者,也需要注意改善以患者为中心的护理.
科学领域:
- 医学伦理 医学伦理
- 手术患者护理手术患者护理
背景情况:
- 知情同意对于道德医疗实践至关重要,它需要能力,信息和非强制性环境.
- 术前同意过程往往是忙的,限制了患者的理解和反思,这与以患者为中心的护理原则相矛盾.
- 手术前立即获得同意的频率没有得到充分记录.
研究的目的:
- 为了确定手术当天在手术前区域签署同意的发生率.
- 确定与同意签署时间和地点相关的因素.
- 突出改善知情同意过程的机会.
主要方法:
- 2021年6月,在一个中心连续两周内对连续的手术患者进行前性研究.
- 测量同意签名和到达手术室之间的时间.
- 外科医生将手术分类为重大或非重大手术.
主要成果:
- 78.7%的患者在手术前的手术日签署了手术同意书.
- 99.6%的麻醉同意书在手术当天签署.
- 西班牙语偏好与同一天签署同意书有显著的关联 (p = .04).
- 79.3%的同意书在手术室启动时间前90分钟内签署.
- 77.8%的重大门诊病例在手术前区域签署了同意书.
结论:
- 同意签名在忙的术前环境中经常发生,这表明需要改进过程.
- 基于语言的同意差异,特别是对于西班牙语说者来说,是有针对性的干预的领域.
- 签署同意的时间和地点为改善以患者为中心的护理和知情同意的质量提供了机会.
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