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Informed consent for procedures in the Neonatal Intensive Care Unit
Joseph Fusco1, Abigail Hanna, Leonard Eisenfeld
1Fairfield University, Wethersfield, USA.
Connecticut Medicine
|July 10, 2008
Summary
Informed consent for neonatal intensive care unit (NICU) procedures varies. Blood transfusions had high consent rates (98%), but umbilical catheterizations were much lower (34%).
Area of Science:
- Neonatal Medicine
- Medical Ethics
- Healthcare Policy
Background:
- Informed consent for procedures in Neonatal Intensive Care Units (NICUs) is debated.
- While blood transfusions universally require documented consent, other procedures like umbilical catheterizations may not.
- Current practices and policies regarding consent in NICUs lack standardization.
Purpose of the Study:
- To evaluate the rates of obtaining informed consent for specific procedures in a Neonatal Intensive Care Unit.
- To compare consent rates for blood transfusions versus umbilical catheterizations.
- To explore factors influencing consent rates and review national NICU consent policies.
Main Methods:
- Retrospective chart review of 116 neonates at Connecticut Children's Medical Center (CCMC).
- Analysis of consent documentation for blood transfusions, umbilical vein catheterizations, and umbilical arterial catheterizations.
- Comparative review of national NICU consent policies from eight children's hospitals.
Main Results:
- Consent for blood transfusions was obtained in 98% of cases.
- Consent for umbilical vein and arterial catheterizations combined was obtained in only 34% of cases.
- Significant disparity noted in consent documentation between transfusions and catheterizations.
Conclusions:
- There is a significant gap in obtaining and documenting informed consent for umbilical catheterizations compared to blood transfusions in the NICU.
- Further research into family expectations is needed to inform policy revisions.
- Standardizing consent policies across Neonatal Intensive Care Units is recommended.
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