Spotlight on patient consent

Graduate midwife, Zoe Lock is conducting timely research to improve Victoria’s documented consent practices for induced labour. By Linda Belardi.

When Victorian midwife, Zoe Lock, began researching the area of induced labour she was struck by the state’s low levels of documented informed consent.

As few as 12 per cent of women had formally recorded their consent, prompting Lock to further investigate the knowledge and understanding of women who have had an induced labour.

Induction levels across the state, and the nation, have been increasing and women often say they have minimal understanding of the risks and benefits of induction and the alternatives available to them.

To address the poor rates of recorded consent, Lock is currently developing and piloting a standardised consent form for women and midwives. In the consent form, women would be required to read an information pamphlet to inform them of all aspects of the procedure.

The Department of Health in Victoria is closely following the outcomes of the research in order to determine the suitability of the consent form for a state-wide roll out.

In recognition of her timely and innovative research, Lock from the Mercy Hospital for Women is one of five nursing professionals in the running for the graduate nurse of the year award at the 2012 HESTA Australian nursing awards to be announced on Thursday.

Nominated by her Director of Nursing, Lock’s research, completed through a Lyn Tuttle scholarship award, has the potential to improve women’s choice, informed decision-making and to transform the state’s practices around the documentation of consent.

Lock’s clinical audit at the Mercy Hospital revealed low levels of documented written consent, which coincided with the Department of Health’s own statewide audit of hospitals.

“From my clinical experience, it seems that women have often little understanding of the actual process of induction of labour, why they are being induced and often the risks of the procedure,” she tells Nursing Review.

“Patients need to know [induced labour] means more monitoring during labour and a higher chance of complications such as epidural, caesarian section and haemorrhage.”

While not a legal requirement in Victoria, Locke says other states such as WA mandate documented consent.

Lock says it is important for women to make informed choices and to feel empowered during the birthing process.

Efforts are being made by the Department of Health to reduce the induction rate in the face of rising numbers which may reflect a clinician’s preference rather than evidence-based practice.

She says evidence shows that when women are informed and are made an integral part of the decision-making process it increases their satisfaction with their labour and birthing experience.
The pilot study will examine the knowledge and experiences of a group of women who have used the consent form compared to a group prior to its implementation.

The consent form is due to be finalised by September.

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