{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T20:39:34Z","timestamp":1770410374606,"version":"3.49.0"},"reference-count":7,"publisher":"IMR Press","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Hosp Med"],"published-print":{"date-parts":[[2018,5,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Neck of femur fractures and their subsequent operative fixation are associated with high rates of perioperative morbidity and mortality. Consenting in this setting is suboptimal with the Montgomery court ruling changing the perspective of consent. This quality improvement project assessed the adequacy of consenting against British Orthopaedic Association-endorsed guidance and implemented a series of changes to improve the documentation of risks associated with surgery for fractured neck of femur.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Seventy consecutive patients who underwent any operative fixation of a neck of femur fracture were included over a 6-month period at a single centre. Patients unable to consent or without electronic notes were excluded. Consent forms were analysed and the documented potential risks or complications associated with surgery were compared to British Orthopaedic Association-endorsed guidance. A series of changes (using the plan, do study, act (PDSA) approach) was implemented to improve the adequacy of consent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Documentation of four out of 12 potential risks or complications was recorded in &lt;50% of cases for patients with intracapsular fractures (n=35), and documentation of seven out of 12 potential risks or complications was recorded in &lt;50% of cases for patients with extracapsular fractures (n=35). Re-audit following raising awareness and attaching consent guidance showed 100% documentation of potential risks or complications in patients with intracapsular and extracapsular fractures (n=70). A neck of femur fracture-specific consent form has been implemented which will hopefully lead to sustained improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Consenting patients with fractured neck of femur for surgery in the authors' unit was suboptimal when compared to British Orthopaedic Association-endorsed consent guidance. This project has shown that ensuring such guidance is readily available has improved the adequacy of consent. The authors hope that introduction of a neck of femur fracture-specific consent form within their unit will lead to sustained adequate documentation of risks associated with surgery.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.12968\/hmed.2018.79.5.284","type":"journal-article","created":{"date-parts":[[2018,5,4]],"date-time":"2018-05-04T13:21:08Z","timestamp":1525440068000},"page":"284-287","source":"Crossref","is-referenced-by-count":3,"title":["Improving consent in patients undergoing surgery for fractured neck of femur"],"prefix":"10.31083","volume":"79","author":[{"given":"Gajendiran","family":"Thiruchandran","sequence":"first","affiliation":[{"name":"Registrar, Department of Trauma and Orthopaedics, Frimley Park Hospital, Camberley, Surrey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew R","family":"McKean","sequence":"additional","affiliation":[{"name":"Core Surgical Trainee, Department of Trauma and Orthopaedics, Ashford and St Peter's Hospitals NHS Foundation Trust, Chertsey, Surrey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Branavan","family":"Rudran","sequence":"additional","affiliation":[{"name":"Foundation Year 2 Doctor, Department of Trauma and Orthopaedics, Ashford and St Peter's Hospitals NHS Foundation Trust, Chertsey, Surrey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed A","family":"Imam","sequence":"additional","affiliation":[{"name":"Senior Upper Limb Fellow, Department of Trauma and Orthopaedics, Ashford and St Peter's Hospitals NHS Foundation Trust, Chertsey, Surrey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keefai","family":"Yeong","sequence":"additional","affiliation":[{"name":"Consultant Orthogeriatrician and Quality Improvement Lead, Department of Trauma and Orthopaedics, Ashford and St Peter's Hospitals NHS Foundation Trust, Chertsey, Surrey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdel","family":"Hassan","sequence":"additional","affiliation":[{"name":"Consultant Orthopaedic Surgeon, Department of Trauma and Orthopaedics, Ashford and St Peter's Hospitals NHS Foundation Trust, Chertsey, Surrey KT16 0QA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"16242","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.90B4.20497"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1308\/rcsann.2016.0277"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1308\/003588412X13171221591970"},{"key":"B8","unstructured":"Langley GL, Moen R, Nolan KM, Nolan TW, Norman CL, Provost LP. 2009. The Improvement Guide: A Practical Approach to Enhancing Organizational Performance. 2nd edition. San Francisco: Jossey-Bass Publishers"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.4037\/ajcc2015455"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1308\/003588407X160846"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2010.11.010"}],"container-title":["British Journal of Hospital Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.magonlinelibrary.com\/doi\/pdf\/10.12968\/hmed.2018.79.5.284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T10:04:21Z","timestamp":1770372261000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.imrpress.com\/journal\/BJHM\/79\/5\/10.12968\/hmed.2018.79.5.284"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,5,2]]},"references-count":7,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2018,5,2]]}},"alternative-id":["10.12968\/hmed.2018.79.5.284"],"URL":"https:\/\/doi.org\/10.12968\/hmed.2018.79.5.284","relation":{},"ISSN":["1750-8460","1759-7390"],"issn-type":[{"value":"1750-8460","type":"print"},{"value":"1759-7390","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,5,2]]}}}