Date of Conferral



Doctor of Nursing Practice (DNP)




Barbara Niedz


Each year, over 50 million surgical and nonsurgical inpatient procedures are performed and yet, shared decision making between patients and health care providers is not achieved. Obtaining patients' informed consent is part of a nurse's daily routine during admissions and before a procedure. The purpose of this project was to evaluate evidence to answer the practice-focused question regarding support for a policy change to implement a nurse-driven informed consent protocol. The systematic literature review was conducted using the adapted literature review by Souz, Silva, and Carvalho, which consisted of 6 levels for evaluating evidence. A total of 15 articles were graded using the updated Johns Hopkins nursing evidence-based practice model. Evidence from the literature review showed that nurses had several roles in the informed consent process: advocate, communicator, and witness. A modified Real Time Delphi 2 round survey was used to measure an expert panel's reaction to the systematic review and to evaluate a nurse-driven informed consent protocol. The results showed consensus from the expert panel (n=16; 81% agreement) for implementing a nurse-driven informed consent protocol, with Cronbach's Alpha, α = .70 for internal consistency and reliability, and Fischer's exact test yielded p = 1.0, showing no differences between staff nurses and managers in advocating for a policy change. Implications for positive social change include improving a nursing process, and impacting patient outcomes, and encouraging collaborative decision-making in health care.

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Nursing Commons