Informed Consent Knowledge and Practices Among Nurses in a Tertiary Care Hospital: A Cross-Sectional Study

ABSTRACT Background: The concept of informed consent is an ethical and legal principle that is integral to the practice or framework of modern health care and is essential to patients' autonomy in and involvement of the healthcare system in the process of shared decision making. Nurses have a key frontline role in the consent process, but a lack of information, institutional constraints and workload could affect consent processes. The purpose of the present study was to appraise the level of knowledge and practice of informed consent in nurses working in the tertiary level hospitals in Lahore, Pakistan. Methods: Descriptive cross sectional design was used. The patients were obtained from Jinnah Hospital and Lahore General Hospital in Lahore. There were 202 registered nurses that were recruited using simple random sampling. The data were gathered using an adapted structured questionnaire with 21 items and five point Likert scale, divided into three domains: knowledge (Items 1-5, 21), practice (Items 6-15, 18-20) and barriers (Items 16-17). Data were analysed with SPSS version 25, descriptive statistics were frequencies, percentages, means, standard deviations. Results: There was medium knowledge score for nurses (mean = 3.13; 62.6%). There was overall more consistent practice-related activities (mean = 3.78; 75.6%). Moderate barriers were reported with a mean score of 3.35 (67.0%) as it related to communication barriers, scope-of-practice ambiguities. Importantly, no one out of a total participant population of 202 had been trained already on informed consent. Conclusion: The conclusion is that although informed consent practices are a routine part of nurses' practice, their conceptual understanding and clarity about the ethical and legal implications of informed consent need to be strengthened. Structured training and workshops; standard institutional procedure and guides; supportive clinical environment are recommended to enable patient centeredness of care in Ethical aspects. Keywords: Informed consent, Nurses, knowledge, practice, patient autonomy, tertiary care hospital, nursing ethics and Pakistan, a cross sectional study.