Date of Award

Spring 5-26-2022

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Jud Simonds, DNP, RN, RN-NE, RN-BC


Purpose of Project: The purpose of this project is to utilize electronic consents (eConsents) with ancillary applications as an evidence-based intervention to reduce consent errors.

Background: Studies show that paper-based handwritten forms have an error rate of up to 50%. Consent errors, especially in the preparation of surgery, are not merely documentation errors but patient safety pitfalls that allow for incorrect surgeries or financial loss due to aborted or delayed interventional cases. Internal organizational evidence indicates the implementation of an evidence-based opportunity as there was no use of electronic tools for consents utilized in the inpatient setting.

Methods: Inpatient departments were provided tablets that contain a consent application connected with the electronic medical record (EMR). Only blood and surgical consents were transformed into eConsent format. The electronic form is automatically attached to patient’s EMR to prevent misplacement and ease of access for all treatment team members. System-wide education was provided to nursing staff on how to access eConsents when preparing the patient for surgery as well as associated policy implications. Collaboration with analysts, leadership, and clinicians was essential to ensuring successful inpatient operational use when launched in May 2021. Metrics were tracked over an additional five months post-intervention.

Results: The primary outcome of reducing the eConsent error rate per patient day indicated an overall decrease of 42% from January 2021 to October 2021. However, this decrease comparing 5 months pre-intervention versus 5 months post-intervention and the associated result of the two-tailed independent samples t-test was not significant based on an alpha value of .05, t(8) = -0.42, p = .686. Secondary outcomes showed a steadily increase in eConsent usage between May 2021 to October 2021.

Evaluation: eConsents have proven worthy for surgical consents and in the reduction of consent error and continued use. Considerations should be made to expand eConsents to other types of consent forms not only for the consolidation of patient documentation and enhanced workflow but to further pursue safe patient practices and prevent documentation error. Nursing informatics is essential to coordinating evidence-based interventions on electronic healthcare platforms that also marry well with bedside operations and workflows.

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