Informed Consent in Clinical Practice: Importance, Significance, and Challenges

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Evidence based nursing
Outline of Clinical Issue
Brief description
Obtaining informed consent is the cornerstone of clinical ethical research and care. Even though much has been said about the need
and importance of informed consent, it is still difficult to understand the nature, validity and effectiveness of consent. As a concept, it
is difficult to comprehend and even more difficult to implement in clinical practice. Nurses often face a dilemma when treating a
patient who has lost their cognitive skills and as a result is unable to make an informed consent.
Significance of the issue
The need for informed consent arises when the patient or needs to provide health-related information. However, the patient
sometimes is unable to understand the gravity of things and make a hasty decision (Ncbi, 2019). They are required to comprehend
the information given to them and then make an autonomous and informed decision, which the nurses and clinical professionals
have to abide by.
Background information
The concept of informed consent is a recent one and it shows how rapidly has medicine and practice undergone rapid development.
It first appeared in 1957 and does not have clear traces to any medical tradition in history. It was a move to perceive the patient or
the care seeker as an equal partner and the physician’s obligation to inform and educate them about the facts.
Prevalence and incidence rate of the problem
Informed consent can be provided by a person under optimal conditions and without any form of external pressure like that of time or
resources. In case the person is found to be incompetent to consent about their own health decisions, a surrogate is appointed who
is trusted to make decisions on their behalf (Ncbi, 2012). However, it is difficult to decipher when a person is incompetent and then
choose a surrogate who has the best interests of their ward in mind.
Risks involved
Informed consent is a concept that aims to provide the patient information regarding the risks, benefits and complications of their
healthcare procedures or medicines. The care plan or treatment will start if the patient, after comprehending the provided information
agrees to it (Ncbi, 2015). The risk arises in most cases when the patients are not informed about the involved risks and found
themselves in the dark. They later go on to condemn the doctor and their approach (Blease et al. 2016).
Need for using an evidence-based approach
Evidence-based practice approach is varied form the much popular traditional form of practice where work systems continue to be
like they have been without any major changes. Whereas, in evidence-based practice, a clinical problem is solved through research

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Evidence based nursing
and evidence. This is much more scientific and logical rather than basing practice decisions on tradition, intuitions or personal
preferences. It also helps to ensure that the practice patterns are uniform as they are based on scientific evidence.
Clinical Question
Identify your clinical question, using the PICO format
Population How does the chosen intervention plan
impact the population of patients who are
able or unable to make an informed consent?
Intervention How does the use of informed consent benefit
the patient population?
Comparison Why is informed consent preferred to
uninformed or no consent?
Outcome What is the impact of informed consent on the
health outcomes of the chosen patient
population?
Identify the domain
The domain is of human response
Evidence Search
Description of the evidence-based search strategy
The evidence-based search strategy is one where the resources are opted based on the evidence they provide. The PICO questions
were taken as the topics and keywords for search.
Recency of information
The articles or the sources of information were screened on the basis of when the journal was published. Ideally, all the articles have
been published after 2015. As informed consent is recently developed topic hence, it is important to have up to date information
regarding it.
How you narrowed your search to find relevant information

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Evidence based nursing
Broadening or narrowing of searches depends on the availability of information. Since the information was abundantly available, the
scenario was further limited to only clinical practice and issues arising in nursing care. Also, the patient and public understanding of
the concept was included along with the definition of ideal clinical practice as they were thought to be influential for the chosen topic.
Hierarchy of evidence
Types of studies that you considered
appropriate to include
Depending on the nature of the topic
two journals, one expert opinion and
two quantitative studies were chosen.
The nature of the chosen articles was
such as it was important to know the
public and patient ideologies related to
the concept which was gained from two
journals. Whereas the quantitative
studies provide evidence-based
inferences.
Key search terms
Informed consent, informed consent for
clinical treatment, Consent and nursing
scenarios, ideal consent
Key search strategies
Boolean operators “and” was used to
narrow the use of informed consent in
clinical practice.
Inclusion or exclusion criteria that you applied and why
Since the search was narrowed to include only evidence from clinical practice and clinical researches, evidence sources about
clinical researches were ignored. Also, the recency and validity of the sources were considered as an inclusion principle.
Publication types
One clinical guidelines article, two journal articles and two quantitative studies were included.
The rationale for selecting the five sources
Ra
nd
om
ise
d
tri
al
stu
dy
Quantitative
survey study
Clinical guidelines
Editorial journals