Impact of a palliative care program on end-of-life care in a neonatal intensive care unit

Impact of a palliative care program on end-of-life care in a neonatal intensive care unit

Younge N; Smith PB; Goldberg RN; Brandon DH; Simmons C; Cotten CM; Bidegain M

Journal Of Perinatology

2014

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.Journal of Perinatology advance online publication, 23 October 2014; doi:10.1038/jp.2014.193.

2014-10

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