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Tag No.: A0955
Based on record review and interview the facility failed to properly execute an informed consent form for 1 (SP #1) of 4 sampled patients
Findings include:
Record review showed sample patient (SP) #1 informed consent for hysterectomy and related procedure (s) dated 04/16/2019, and informed consent for authorization for operative and other invasive procedures dated 04/17/2019 do not have the name of the authorized physician who will perform the procedure on the patient.
Above was acknowledged by the Director of Performance Improvement, the Manager of Performance Improvement, and the Risk Manager on 08/21/2019 at 2:30 PM.