Medical record documentation and symptom management at the end of life in the neonatal intensive care unit

Title

Medical record documentation and symptom management at the end of life in the neonatal intensive care unit

Creator

Fortney CA; Steward DK

Publisher

Advances In Neonatal Care

Date

2014

Description

In neonates, the course of illness is often unpredictable and symptom assessment is difficult. This is even truer at the end of life (EOL). Time to death can take minutes to days, and ongoing management of the infant is needed during the time between discontinuation of life-sustaining treatment and death to ensure that the infant remains free of pain and suffering. The symptoms experienced by neonates as they die, as well as best ways to treat those symptoms, are understudied. The purpose of this study was to examine symptoms exhibited by neonates at the EOL and the treatments used to manage those symptoms as documented in the medical record during the last 24 hours of life. The sample included 20 neonates who died at a large children's hospital. This was an exploratory, descriptive study. Descriptive data, such as diagnosis, ongoing therapy at time of treatment withdrawal or withholding, pharmacologic and nonpharmacologic interventions associated with treatment withdrawal, time of treatment withdrawal and death, age at time of death, signs and symptoms exhibited during EOL care, and pain scores, were abstracted from the infant's medical record. Inadequate documentation in the medical record resulted in missing data that made it not possible to fully explore aspects of symptom management during the last 24 hours of life; however, some important results were found. This study showed a difference in the way neonates approach the EOL period. Other findings were that most infants in the study received pain medication, even though pain scores were infrequently documented and drug dosages varied across infants. Finally, documentation of nonpharmacologic interventions utilized at the EOL was also lacking.
2014-10

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).

Type

Journal Article

Citation

Fortney CA; Steward DK, “Medical record documentation and symptom management at the end of life in the neonatal intensive care unit,” Pediatric Palliative Care Library, accessed October 7, 2022, https://pedpalascnetlibrary.omeka.net/items/show/14837.

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