Impact Of A Palliative Care Program On End-of- Life Care In A Neonatal Intensive Care Unit.
Title
Impact Of A Palliative Care Program On End-of- Life Care In A Neonatal Intensive Care Unit.
Creator
Younge N; Smith PB; Goldberg RN; Brandon D; Simmons C; Cotten CM
Identifier
DOI: 10.1038/jp.2014.193
Publisher
Journal Of Perinatology : Official Journal Of The California Perinatal Association
Date
2016
Subject
Benzodiazepines/therapeutic Use; Cause Of Death; Female; Humans; Infant; Infant Death; Infant Newborn; Intensive Care Units Neonatal/organization & Administration; Male; Morphine/therapeutic Use; Palliative Care; Resuscitation Orders; Retrospective Studies; Terminal Care; Withholding Treatment/trends
Description
OBJECTIVE:
Evaluate changes in end-of-life care following initiation of a palliative care program in a neonatal intensive care unit.
STUDY DESIGN:
Retrospective study comparing infant deaths before and after implementation of a Palliative Care Program comprised of medication guidelines, an individualized order set, a nursing care plan and staff education.
RESULT:
Eighty-two infants died before (Era 1) and 68 infants died after implementation of the program (Era 2). Morphine use was similar (88% vs 81%; P =0.17), whereas benzodiazepines use increased in Era 2 (26% vs 43%; P=0.03). Withdrawal of life support (73% vs 63%; P=0.17) and do-not-resuscitate orders (46% vs 53%; P=0.42) were similar. Do-not-resuscitate orders and family meetings were more frequent among Era 2 infants with activated palliative care orders (n=21) compared with infants without activated orders (n=47).
CONCLUSION:
End-of-life family meetings and benzodiazepine use increased following implementation of our program, likely reflecting adherence to guidelines and improved communication.
Evaluate changes in end-of-life care following initiation of a palliative care program in a neonatal intensive care unit.
STUDY DESIGN:
Retrospective study comparing infant deaths before and after implementation of a Palliative Care Program comprised of medication guidelines, an individualized order set, a nursing care plan and staff education.
RESULT:
Eighty-two infants died before (Era 1) and 68 infants died after implementation of the program (Era 2). Morphine use was similar (88% vs 81%; P =0.17), whereas benzodiazepines use increased in Era 2 (26% vs 43%; P=0.03). Withdrawal of life support (73% vs 63%; P=0.17) and do-not-resuscitate orders (46% vs 53%; P=0.42) were similar. Do-not-resuscitate orders and family meetings were more frequent among Era 2 infants with activated palliative care orders (n=21) compared with infants without activated orders (n=47).
CONCLUSION:
End-of-life family meetings and benzodiazepine use increased following implementation of our program, likely reflecting adherence to guidelines and improved communication.
Rights
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).
Citation List Month
March 2016 List
Citation
Younge N; Smith PB; Goldberg RN; Brandon D; Simmons C; Cotten CM, “Impact Of A Palliative Care Program On End-of- Life Care In A Neonatal Intensive Care Unit.,” Pediatric Palliative Care Library, accessed April 25, 2024, https://pedpalascnetlibrary.omeka.net/items/show/10568.