• Maria L Espinosa, Aaron M Tannenbaum, Megha Kilaru, Jennifer Stevens, Mark Siegler, Michael D Howell, and William F Parker.
• Maria L. Espinosa is a medical student at the University of Chicago Pritzker School of Medicine, Chicago, Illinois. Aaron M. Tannenbaum is a fellow at the Division of Pulmonary, Allergy, and Critical Care, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania; a resident in the Department of Medicine, University of Chicago; and a clinical ethics fellow at the MacLean Center for Clinical Medical Ethics, University of Chicago. Megha Kilaru is a research associate at the Center for Healthcare Delivery Science and Innovation, University of Chicago Medicine. Jennifer Stevens is a physician and director of the Center for Healthcare Delivery Science, Beth Israel Deaconess Medical Center, Boston, Massachusetts. Mark Siegler is a physician in the Department of Medicine, University of Chicago, and founding director of the MacLean Center for Clinical Medical Ethics. Michael D. Howell is founder of the Center for Healthcare Delivery Science and Innovation, University of Chicago Medicine; a physician in the Department of Medicine, University of Chicago; and a principal scientist at Google AI, Google, LLC, Mountain View, California. William F. Parker is a physician in the Department of Medicine, University of Chicago, and a clinical ethics fellow at the MacLean Center for Clinical Medical Ethics.
• Am. J. Crit. Care. 2020 May 1; 29 (3): e44e51e44-e51.

BackgroundBundled consent, the practice of obtaining anticipatory consent for a predefined set of intensive care unit procedures, increases the rate of informed consent conversations and incorporation of patients' wishes into medical decision-making without sacrificing patients' or surrogates' understanding. However, the adoption rate for this practice in academic and nonacademic centers in the United States is unknown.ObjectiveTo determine the national prevalence of use of bundled consent in adult intensive care units and opinions related to bundled consent.MethodsA random sample of US hospitals with medical/surgical intensive care units was selected from the AHA [American Hospital Association] Guide. One intensive care unit provider (bedside nurse, nurse manager, or physician) from each hospital was asked to self-reportuse of per-procedure consent versus bundled consent, consent rate for intensive care unit procedures, and opinions about bundled consent.ResultsOf the 238 hospitals contacted, respondents from 100 (42%) completed the survey; 94% of respondents were nurses. The prevalence of bundled consent use was 15% (95% CI, 9%-24%). Respondents using per-procedure consent were more likely than those using bundled consent to self-report performing invasive procedures without consent. Users of bundled consent unanimously recommended the practice, and 49% of respondents using per-procedure consent reported interest in implementing bundled consent.ResultsBundled consent use is uncommon in academic and nonacademic intensive care units, most likely because of conflicting evidence about the effect on patients and surrogate decision makers. Future work is needed to determine if patients, family members, and providers prefer bundled consent over per-procedure consent.Copyright© 2020 American Association of Critical-Care Nurses.

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