Pediatric End-of-Life Care Skills Workshop: A novel, deliberate practice approach
End-of-Life; Simulation; Deliberate Practice; Pediatric Fellows; Pediatrics
INTRODUCTION: Pediatric end of life (EOL) care skills are a high acuity, low occurrence skill set required by pediatric clinicians. Gaps in education and competence for this specialized care can lead to suboptimal patient care and clinician distress when caring for dying patients and their families. METHODS: A half-day workshop using a deliberate practice approach was designed by an inter-professional workgroup including bereaved parent consultants. Pediatric fellows (neonatal-perinatal medicine, critical care, hematology oncology, blood and marrow transplant) and advanced practice providers learned and practiced EOL skills in a safe simulation environment with instruction from interprofessional facilitators and standardized patients. Participant perceived competence (self-efficacy) was measured before, immediately-post, and 3 months post workshop. RESULTS: There were 28 first-time (of 34 total) participants in 4 pilot workshops. Participants reported significantly increased self-efficacy post-workshop for 6 of 9 ratings, which was sustained 3 months afterwards. Most (92%, n=22 of 24 respondents) reported incorporating the workshop training into clinical practice at 3-month follow-up. CONCLUSIONS: With early success of the pilot workshops, future iterative work includes expanding workshops to earlier, interprofessional learners and collecting validity evidence for a competency-based performance checklist tool. A project website (https://z.umn.edu/PECS) was developed for local and collaborative efforts.(1).
Scheurer JM; Norbie E; Bye JK; Villacis-Calderon D; Heith C; Woll A; Shu D; McManimon K; Kamrath H; Goloff N
Acad Pediatr
2022
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1016/j.acap.2022.11.006" target="_blank" rel="noreferrer noopener">10.1016/j.acap.2022.11.006</a>
The Impact Of A Perinatal Palliative Care On Length Of Stay, Icu Days And Invasive Procedures
Objectives
Describe the history, epidemiology, and role of
perinatal palliative care.
Examine the impact of perinatal palliative care on
neonatal outcomes at the University of
Minnesota.
Explore the potential benefits of perinatal palliative
care for the infant, the parent, and the
healthcare system.
Original Research Background. The Perinatal Palliative
Care Program (PPCP) at the University of Minnesota
is a multidisciplinary program involving maternalfetal
medicine, neonatology, genetics and social work.
This team coordinates palliative care services for families
whose infants have prenatally diagnosed lifelimiting
conditions.
Research Objectives. The aim of this study was to
investigate the impact of perinatal palliative care
planning on care provided for infants born with a
life-limiting condition. We hypothesized that perinatal
palliative care planning would decrease length
of stay (LOS), number of neonatal intensive care
unit (NICU) days, and number of invasive
procedures.
Methods. This was a retrospective chart review of infants
with life-limiting conditions treated from 1/01/
11-9/30/14. Infants were identified through PPCP records
and NICU death records. Descriptive statistics
were used to describe the patient populations, continuous
data was analyzed using the Mann-Whitney U
test, and categorical data were analyzed with Fischer’s
exact test.
Results. Twenty-seven infants were identified, 18 in
the PPCP cohort and 9 in the No PPCP cohort. Infants
with an active palliative care plan at birth had a statistically
significant decrease in number of NICU days
(p¼0.001), invasive procedures performed
(p¼0.0008), CPR (p¼0.002) and resuscitation medication
administration (p¼0.008).
Conclusion. Perinatal palliative care is a relatively
recent concept in the field of palliative care medicine.
This study provides novel data that a perinatal palliative
care program can alter interaction with the healthcare
system after birth for newborns with life-limiting
conditions.
Implications for Research, Policy, and
Practice. Given the alteration in interaction with
the medical system after birth, perinatal palliative
care planning may lead to a decreased stress burden
on families, caregivers and the infant. Additionally,
perinatal palliative care planning may decrease cost
of care for these infants. Future research involving
families and caregivers would be informative.
N
Kamrath H; Needle J; Osterholm E; Stover-Haney R
Journal Of Pain And Symptom Management
2016
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
DOI: http://dx.doi.org/10.1016/j.jpainsymman.2015.12.201