(c) The patient must sign in the presence of a witness, to consent for the
surgical procedure. The witness is attesting to the patient's signature, not to the patient's
understanding of the surgical risks. If the adult patient is unconscious, semiconscious, or
is not mentally competent, the consent form may be signed by a family member or legal
(d) If the patient is a minor (usually under the age of 18), the consent
form is signed by a parent or legal guardian. A minor who lives away from home and is
self-supporting is considered emancipated and he may sign.
(e) Legal age is established on a state-by-state basis. Be familiar with
the age of consent for the state in which the health care facility is located and with legal
implications when a person other than the patient signs the consent form.
(f) Legal consent forms must be signed prior to administration of
preoperative medication or any type of mind-altering medication or the document is not
SF 522 must be timed and dated.
Implement doctor's orders for preoperative care.
(a) If ordered, administer an enema. The enema cleanses the colon of
fecal material, which reduces the possibility of wound contamination during surgery.
(b) If ordered, assure that the operative site skin prep (shave) is done.
An operating room technician or other designated person will clean and shave a wide area
surrounding the planned site for the incision. (This may be done in the operating room
immediately before surgery). The skin prep frees the skin of hair and microorganisms as
much as possible, thus decreasing the possibility of them entering the wound via the skin
surface during surgery.
(c) The doctor will give specific directions concerning withholding food
and fluid before surgery. Assure that the order is followed. Typically, the patient may eat
solid food until supper, but can have nothing by mouth (NPO) beginning at midnight before
surgery. Place the NPO sign outside the patient's room. Instruct the patient of the
importance and the reason for being NPO. Remove the water pitcher and the drinking
glass. Clearly mark the diet roster.
(d) If ordered, administer a sedative. The evening before surgery a
hypnotic drug, such as flurazepam hydrochloride (Dalmane) may be given so that the
patient can get a good night's sleep.