Audit of Consent Processes in Elective Orthopaedic Surgery at Federal Medical Centre, Lokoja, Kogi State

Informed consent is a fundamental ethical and legal requirement in surgical practice, yet its quality in Nigerian hospitals has been questioned in the context of power asymmetries between clinicians and patients, literacy limitations, and time pressures. This clinical audit evaluates the quality of informed consent processes for elective orthopaedic surgical procedures at the Federal Medical Centre, Lokoja, Kogi State, North Central Nigeria. A retrospective review of 120 elective orthopaedic surgical case files over twelve months will assess the completeness of written consent documentation, evidence of pre-operative discussion, comprehensibility of consent language, documentation of risks and alternatives, and opportunity for patient questions. Patient recall of consented information will also be assessed through structured post-operative interviews with consenting patients. A documentation compliance score will be derived and cross-referenced with case complexity, surgery type, and grade of the consenting clinician. The study hypothesises that fewer than 60 percent of consent documents meet minimum legal and ethical standards. Findings will be presented to the hospital's ethics committee and clinical governance unit to develop a standardised consent process and training programme. This audit contributes to improving ethical surgical practice standards at Federal Medical Centre Lokoja and provides a model for consent quality improvement applicable to orthopaedic units across North Central Nigeria. Keywords: informed consent, orthopaedic surgery, audit, Lokoja, surgical ethics.