Use of simple visual prompt improves recording of capacity to consent assessments


This study set out to examine the practice of a number of psychiatrists working in a large learning disability service in relation to their recording capacity to consent to treatment and discussions with patients about side effects of medication. A number of measures were introduced to improve practice in the service including the application of a rubber stamp in 2008 to act as a visual prompt for clinicians, and this study reported on the outcome of audits to look at the impact of these.

The researchers completed three audit cycles between 2007 and 2009, examining 26 case notes selected at random in each cycle. They gathered information on recording of capacity and documentation of explanation of potential side effects.

Rates of recording of capacity rose from 30% in 2007 to 51% in 2009  and the study team were able to conclude from their analysis that capacity was more likely to have been recorded if the rubber stamp was present.

They found that the recording of a discussion of side effects was higher than for capacity, but that this showed very little change through the three audit cycles.

The authors conclude that using the rubber stamp was associated with improvements in the recording of capacity assessments.

Improving recording of capacity to consent and explanation of medication side effects in a psychiatric service for people with learning disability: Audit findings, Roy A et al, in Journal of Intellectual Disabilities, 15, 2, 85-92

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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