893 Consenting for Appendicectomy

Appendicitis denotes to the inflammation of the appendix with over 50,000 cases in the UK per year. The treatment of choice is appendicectomy and this is one of the most common operations in the UK. There are nil NICE or King’s College Hospital (KCH) guidance available on consenting for appendicectomy. Thus, guidance from Guy’s and St Thomas’ and Whittingham Health was used as reference and the consent forms at KCH were analysed for all appendicectomies over 2 months. A retrospective observational audit (Cycle 1) was conducted between Dec 2018 – Jan 2019 consisting of 34 patients. It assessed whether common complications were documented clearly and any possible complications. This audit identified that consenting for diagnostic laparoscopy/appendicectomy did not cover many serious complications and was overall inadequate. One of the most common and serious complications was ileus/SBO (occurred in 9%) and was not consented for in 88% of patients. 12% of patients had a normal appendix and this was not consented in 100% of these patients. Later, posters and teaching sessions were created to optimise the consent process for appendicectomy. This was re-audited (Cycle 2) again between June 2019 – July 2019 with 49 patients to identify whether a positive change was identified. It identified that an 12% increase in consenting for ileus/SBO, 10% increase in conversion to open and 47% of individuals started consenting for hernia repair. This work is vital as inadequate consenting can destroy doctor-patient relationship and result in litigation and we encourage clear consenting guideline for appendicectomies across trusts.