title: Universal consent practice in academic intensive care units (ICUs).
abstract: The purpose of this study was to determine national practice for obtaining consent in academic adult intensive care units (ICUs) for routine bedside procedures and to define universal consent rates by patient demographics within our own institution's ICUs.
  
  
  METHODS
  A 10-question survey was sent to the program directors for all U.S. surgical and pulmonary critical care directors regarding consent practices. Further, the adoption of a universal consent protocol in an academic county hospital was studied.
  
  
  RESULTS
  Cross-sectional study: Thirty-seven percent of program directors completed the survey. Consent rates varied from 35% to 97% by procedure, with only 14% using a universal consent document. Providers in Medical ICUs obtained consent more often than in Surgical ICUs for both central line and pulmonary artery catheter placement (82.8% and 93.1% vs. 52.6% and 52.6%, respectively). Prospective cohort study: At our institution, 90% of 363 patients or their proxies signed universal consent for procedures, 4.4% consent with exemptions, while 5.2% refused. Insured patients were 2.7 times more likely to sign full universal consent for bedside ICU procedures than uninsured patients.
  
  
  CONCLUSIONS
  There was a national variation in ICU consent practices with an interest in a wider usage of universal consent protocols. The latter was adopted differentially based on patient demographics. Universal consent was widely accepted at our institution.
authors.affiliation: LSU Health Science Center, New Orleans, LA, USA.
authors.forename: Lance
authors.initials: L
authors.lastname: Stuke
authors.forename: Andrew
authors.initials: A
authors.lastname: Jennings
authors.forename: Mark
authors.initials: M
authors.lastname: Gunst
authors.forename: Tracy
authors.initials: T
authors.lastname: Tyner
authors.forename: Randall
authors.initials: R
authors.lastname: Friese
authors.forename: Terence
authors.initials: T
authors.lastname: O'Keeffe
authors.forename: Heidi
authors.initials: H
authors.lastname: Frankel
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000592:standards / Q000706:statistics & numerical data*; D007348:Insurance, Health; D007362:Intensive Care Units / Q000458:organization & administration*; D008297:Male; D016134:Organizational Policy; D044469:Racial Groups; D011795:Surveys and Questionnaires; D014481:United States