Informed consent for procedures in the Neonatal Intensive Care Unit

Establishing those procedures that require documentation of specific informed consent in a Neonatal Intensive Care Unit (NICU) setting remains controversial. Although documentation of specific informed consent for blood transfusions is universally mandated, consent for other procedures such as umbilical catheterizations may or may not be obtained and/or documented. In a retrospective study, medical charts of 116 neonates were reviewed to determine if consent for umbilicalvein and arterial catheterizations, blood transfusions, and procedures that require documentation of consent at Connecticut Children's Medical Center (CCMC), had been obtained. Consent for blood transfusions was obtained 98% (87/89) of the time compared with 34% (64/191) for umbilical vein and arterial catheterizations combined. Variables contributing to decreased consent rates for catheterizations were explored as were alternatives that would increase the consent rate. National Neonatal Intensive Care Unit consent policies from eight children's hospitals were reviewed to further evaluate current practice. Future research investigating expectations of families would be useful to create policy revisions.