Audiovisual Modules to Enhance Informed Consent in the ICU: A Pilot Study

Tyler J Loftus; Maria E Alfaro; Tiffany N Anderson; Travis W Murphy; Olga Zayko; John P Davis; Zachary A Hothem; Dijoia B Darden; Rohit P Patel; Wanda Whittet; Edward K McGough; Azra Bihorac; Chasen A Croft; Martin D Rosenthal; R Stephen Smith; Erin L Vanzant; Fredrick A Moore; Scott C Brakenridge; Gabriela L Ghita; Babette A Brumback; Alicia M Mohr; Philip A Efron

doi:10.1097/CCE.0000000000000278

Audiovisual Modules to Enhance Informed Consent in the ICU: A Pilot Study

Crit Care Explor. 2020 Nov 23;2(12):e0278. doi: 10.1097/CCE.0000000000000278. eCollection 2020 Dec.

Authors

Tyler J Loftus¹, Maria E Alfaro¹, Tiffany N Anderson¹, Travis W Murphy², Olga Zayko¹, John P Davis³, Zachary A Hothem⁴, Dijoia B Darden¹, Rohit P Patel², Wanda Whittet⁵, Edward K McGough⁶, Azra Bihorac⁷, Chasen A Croft¹, Martin D Rosenthal¹, R Stephen Smith¹, Erin L Vanzant¹, Fredrick A Moore¹, Scott C Brakenridge¹, Gabriela L Ghita⁸, Babette A Brumback⁸, Alicia M Mohr¹, Philip A Efron¹

Affiliations

¹ Department of Surgery, University of Florida Health, Gainesville, FL.
² Department of Emergency Medicine, University of Florida Health, Gainesville, FL.
³ Department of Surgery, University of Virginia School of Medicine, Charlottesville, VA.
⁴ Lee Health, Fort Myers, FL.
⁵ College of Nursing, University of Florida Health, Gainesville, FL.
⁶ Department of Anesthesiology, University of Florida Health, Gainesville, FL.
⁷ Department of Medicine, University of Florida Health, Gainesville, FL.
⁸ Department of Statistics, University of Florida Health, Gainesville, FL.

Abstract

Obtaining informed consent for commonly performed ICU procedures is often compromised by variability in communication styles and inadequate verbal descriptions of anatomic concepts. The objective of this study was to evaluate the efficacy of an audiovisual module in improving the baseline knowledge of ICU procedures among patients and their caregivers.

Design: Prospective, observational study.

Setting: Forty-eight-bed adult surgical ICU at a tertiary care center.

Subjects: Critically ill surgical patients and their legally authorized representatives.

Interventions: An audiovisual module describing eight commonly performed ICU procedures.

Measurements and main results: Fifty-nine subjects were enrolled and completed an 11-question pre- and postvideo test of knowledge regarding commonly performed ICU procedures and a brief satisfaction survey. Twenty-nine percent had a healthcare background. High school was the highest level of education for 37% percent of all subjects. Out of 11 questions on the ICU procedure knowledge test, subjects scored an average 8.0 ± 1.9 correct on the pretest and 8.4 ± 2.0 correct on the posttest (p = 0.055). On univariate logistic regression, having a healthcare background was a negative predictor of improved knowledge (odds ratio, 0.185; 95% CI, 0.045-0.765), indicating that those with a health background had a lower probability of improving their score on the posttest. Among subjects who did not have a healthcare background, scores increased from 7.7 ± 1.9 to 8.3 ± 2.1 (p = 0.019). Seventy-five percent of all subjects indicated that the video was easy to understand, and 70% believed that the video improved their understanding of ICU procedures.

Conclusions: Audiovisual modules may improve knowledge and comprehension of commonly performed ICU procedures among critically ill patients and caregivers who have no healthcare background.

Keywords: communication; health literacy; informed consent; intensive care unit; procedures; surgery.

Abstract

Grants and funding