We are looking to revise our blood consent process so it is applicable at all our practice sites (including those where a physician may not always be readily available) and of course remains compliant with regulations.  In reviewing various requirements, AABB and CAP discuss the elements of consent for transfusion, but are silent on who may administer that consent.  The Joint Commission states that “Obtaining informed consent presents an opportunity to establish a mutual understanding between the patient and the licensed independent practitioner or other licensed practitioners with privileges about the care, treatment, and services that the patient will receive”.  By our reading, this indicates that other licensed providers who are not physicians (eg, nurse practitioners, physician assistants, registered nurses) can obtain informed consent.  We would like to benchmark this practice, and so we are interested in who you allow to obtain informed consent in your hospital? 

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 Our informed consent policy states that the practitioner, advanced mid-level provider, resident, or fellow performing a medical intervention or procedure which requires specific informed consent has primary responsibility for overseeing the informed consent process or verifying that appropriate informed consent is obtained.

Additionally, these responsibilities may be delegated, after an order has been placed for the procedure, to a registered nurse (RN) or other allied health provider performing or providing the medical intervention, depending on the relative risk of the procedure and the training or experience of the health care team member,

 

Informed consent is implied in emergency situations. A discussion and signed form is not required in these cases. The provider should document the emergent circumstances in the medical record and what reasonable attempts were made to reach a party with the power to consent.