Hostname: page-component-586b7cd67f-t7czq Total loading time: 0 Render date: 2024-11-22T04:44:53.176Z Has data issue: false hasContentIssue false

The impact of the introduction of consultant radiographer-led consent for multiple myeloma bone metastases patients

Published online by Cambridge University Press:  15 February 2021

Sarah Griffiths*
Affiliation:
The Radiotherapy Department, Bristol Cancer Institute, Bristol Haematology and Oncology Centre, Bristol, UK
*
Author for correspondence: Sarah Griffiths, The Radiotherapy Department, Bristol Cancer Institute, Bristol Haematology and Oncology Centre, Horfield Road, BristolBS2 8ED, UK. Tel: +44 117 342 4285. E-mail: [email protected]

Abstract

Background:

The role of the Consultant Radiographer (CR) is crossing traditional boundaries to encompass duties and responsibilities normally performed by the medical profession. Changes and streamlining of radiotherapy (RT) services result as therapeutic radiographers are taking on the responsibility of informed consent.

Purpose:

This article discusses and evaluates the legal, ethical and practical aspects of informed consent within the trust and how they have implemented the introduction of CR-led consent. It reports on the impact on the waiting times for treatment and user experience for myeloma patients receiving RT for pain relief from bone metastases.

Materials and methods:

A literature search was conducted using PubMed, CINAHL, Medline and Cochrane library using the term ‘informed consent’. The legal, ethical and practical aspects were compared to the current system and then was used to inform the development of a new pathway. Data were analysed from the department’s statistics for waiting times and the number of treatment courses.

Results and conclusions:

CR-led informed consent has streamlined the patient pathway and has improved patient care and experience.

Type
Original Article
Copyright
© The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Department of Health. Meeting the challenge: a strategy for the Allied Health Professions. http://nursingleadership.org.uk/publications/meetingthechallenge.pdf. Accessed on 15th July 2020.Google Scholar
Kennedy, F, McDonnell, A, Gerrish, K, Howarth, A, Pollard, C, Redman, J. Evaluation of the impact of nurse consultant roles in the United Kingdom: a mixed method systematic literature review. J Adv Nurs 2012; 68 (4): 721742.CrossRefGoogle ScholarPubMed
The Royal College of Radiologists. Guide to job planning in clinical oncology. https://www.rcr.ac.uk/publication/guide-job-planning-clinical-oncology-third-edition. Accessed 15th July 2020.Google Scholar
Booth, L, Henwood, S, Miller, P. Reflections on the role of consultant radiographers in the UK: what is a consultant radiographer? Radiography 2016; 22 (1): 3843.CrossRefGoogle Scholar
Paterson, A. Consultant radiographers – the point of no return? Radiography 2009; 15 (1): 25.CrossRefGoogle Scholar
Henwood, S, Booth, L, Miller, P. Reflections on the role of consultant radiographers in the UK: the perceived impact on practice and factors that support and hinder the role. Radiography 2016; 22 (1): 4449.CrossRefGoogle Scholar
Association of Surgeons of Great Britain and Ireland. Issues in professional practice: informed consent. https://www.asgbi.org.uk/userfiles/file/ipp/_iipp-informed-consent-may-2013-as-gone-to-press.pdf. Accessed 15th July 2020.Google Scholar
Everett, S, Griffiths, H, Nandasoma, U et al. Guideline for obtaining valid consent for gastrointestinal endoscopy procedures. BMJ 2016. doi: 10.1136/gutjnl-2016-311904.Google ScholarPubMed
Nandasoma, U. A question of consent. MDU J 2015. https://mdujournal.themdu.com/issue-archive/issue-1/a-question-of-consent. Accessed on 15th July 2020.Google Scholar
Department of Health. Reference guide to consent for examination or treatment. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/138296/dh_103653__1_.pdf. Accessed on 15th July 2020.Google Scholar
General Medical Council. Consent: patients and doctors making decisions together. https://www.gmc-uk.org/static/documents/content/Consent_-_English_0617.pdf. Accessed on 15th July 2020.Google Scholar
Herring, J. Medical Law and Ethics, 8th edition. Oxford: Oxford University Press, 2020: 151233.CrossRefGoogle Scholar
Dyer, C. Doctors should not cherry pick what information to give patients, court rules. BMJ 2015. doi: 10.1136/bmj.h1414.Google ScholarPubMed
Hall, D, Prochazka, M, Fink, A. Informed consent for clinical treatment. CMAJ 2012; 184 (5): 533540.CrossRefGoogle ScholarPubMed
Lavelle-Jones, C, Byrne, D, Rice, P, Cuschieri, A. Factors affecting quality of informed consent. BMJ 1993, 885890.CrossRefGoogle ScholarPubMed
Hekkenberg, R, Irish, J, Rotstein, L, Brown, D, Gullane, P. Informed consent in head and neck surgery: how much do patients actually remember? J Otolaryngol 1997; 26 (3): 155159.Google ScholarPubMed
Betti, S, Sironi, A, Saino, G, Ricci, C, Bonavina, L. Effect of the informed consent process on anxiety and comprehension of patients undergoing oesophageal and gastrointestinal surgery. J Gastrointest Surg 2011; 15: 922927.CrossRefGoogle Scholar
Consumers Health Forum of Australia. Informed consent in healthcare: an issues paper. https://chf.org.au/sites/default/files/informed_consent_issues_paper.pdf. Accessed on 15th July 2020.Google Scholar
Queensland Health. Guide to informed decision-making in healthcare. https://www.health.qld.gov.au/consent/documents/ic-guide.pdf. Accessed on 15th July 2020.Google Scholar
Westhoff, P, de Graeff, A, Monninkhof, E et al. Quality of life in relation to pain response to radiation therapy for painful bone metastases. Int J Radiat Oncol Biol Phys 2015; 93 (3): 694701.CrossRefGoogle ScholarPubMed
Ribas, Y, Hotouras, A, Wexner, S, D’Hoore, A. Shared decision-making and informed consent process in rectal cancer treatment: weighing up oncological and functional outcomes. Colorectal Dis 2016; 18 (1): 912.CrossRefGoogle ScholarPubMed
McKneally, M, Martin, D. An entrustment model of consent for surgical treatment of life-threatening illness: perspective of patients requiring oesophagectomy. J Thorac Cardiovasc Surg 2000; 120 (2): 264269.CrossRefGoogle Scholar
The Medical Protection Society. Consent – the basics – England. https://www.medicalprotection.org/uk/articles/eng-consent-the-basics. Accessed 15th July 2020.Google Scholar
Esmaeili, M, Cheraghi, M, Salsali, M. Barriers to patient-centered care: a thematic analysis study. Int J Nurs Knowl 2013. doi: 10.1111/2047-3095.12012 Google ScholarPubMed
West, E, Barron, D, Reeves, R. Overcoming the barriers to patient-centered care: time, tools and training. J Clin Nurs 2005; 4 (14): 435443. doi: 10.1111/j.1365-2702.2004.01091.x CrossRefGoogle Scholar
Fink, A, Prochazla, A, Henderson, W et al. Enhancement of surgical informed consent by addition of repeat back: a multicentre, randomized controlled clinical trial. Ann Surg 2010; 252 (1): 2736, doi: 10.1097/SLA.0b013e3181e3ec61 CrossRefGoogle Scholar
Department of Health. Toolkit for producing patient information. https://www.uea.ac.uk/documents/246046/0/Toolkit+for+producing+patient+information.pdf. Accessed on 15th July 2020.Google Scholar
Aubin, M, Giguère, A, Martin, M et al. Interventions to improve continuity of care in the follow-up of patients with cancer. Cochrane Database Syst Rev 2012. doi: 10.1002/14651858.CD007672.pub2 CrossRefGoogle ScholarPubMed
Cabana, N, Jee, S. Does continuity of care improve patient outcomes? J Fam Pract 2004; 53 (12): 974980.Google ScholarPubMed
University Hospitals Bristol and Weston NHS Foundation Trust. Policy for Consent to Examination or Treatment. http://www.uhbristol.nhs.uk/media/3122849/17-591_-_foi_response_-_attachment.pdf. Accessed on 15th July 2020.Google Scholar
The College of Radiographers. Obtaining consent: a clinical guideline for the diagnostic imaging and radiotherapy workforce. https://www.sor.org/sites/default/files/documentversions/updated_22_jan_2020_131117_002.pdf. Accessed on 15th July 2020.Google Scholar
Schenker, Y, Meisel, A. Informed consent in clinical care: practical considerations in the effort to achieve ethical goals. J Am Med Assoc 2011; 305 (11): 11301131. http://jamanetwork.com/journals/jama/fullarticle/646101. Accessed on 15th July 2020.CrossRefGoogle ScholarPubMed
Agency for Healthcare Research and Quality. Making healthcare safer II: an updated critical analysis of the evidence for patient safety practices. https://www.ncbi.nlm.nih.gov/books/NBK133402/. Accessed on 15th July 2020.Google Scholar