Talking to families when death becomes a likely outcome-a pilot simulation programme to improve end of life conversations during and around PICU admission

Title

Talking to families when death becomes a likely outcome-a pilot simulation programme to improve end of life conversations during and around PICU admission

Creator

Sidgwick P;Du Pre P;Skellett S

Publisher

Pediatric Critical Care Medicine

Date

2018

Subject

conversation;death;simulation;advanced cancer;bone marrow transplantation;cancer staging;cerebrovascular accident;Child;conference abstract;controlled study;craniofacial surgery;experimental therapy;human;immunology;life sustaining treatment;multidisciplinary team;nursing role;oncology;palliative therapy;pulmonary hypertension;treatment failure

Description

Aims & Objectives: End of life conversations form the basis of many complex communication scenarios in paediatric intensive care (PICU). These conversations are sometimes initiated late in the disease process. Anecdotal evidence is that many clinicians shy away from the subject matter for a wide variety of reasons. A multidisciplinary, one-day pilot simulation course to address this unmet need was designed by the PICU and palliative care teams for members of the multidisciplinary team (MDT) who admit to our PICU. Methods The course was oversubscribed and candidates were evenly drawn from medical and senior nursing roles; specialties represented included PICU, immunology, bone marrow transplant, oncology, pulmonary hypertension and craniofacial surgery. A range of clinically complex and personally challenging clinical scenarios were developed for use with experienced educational actors. These included: Previously fit and well child post cerebrovascular accident with a deeply religious family Child with end stage cancer whose parents had the option of an experimental treatment Child with advanced pulmonary hypertension whose parents are angry about failure of treatment Child with incurable malignancy with parents reluctant to ask for withdrawal of life sustaining treatment but who secretly wish it to be offered A demonstration scenario was run by the faculty for all candidates and four simulations were run in groups of four. Simulation safety and debrief tools were utilised throughout Results Feedback from the day was universally positive. Conclusions There is significant need for this course. Plans are now under way to extend it to a wider cohort of the PICU MDT and run it on a regular basis.

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

November 2018 List

Pages

9th Congress of the World Federation of Pediatric Intensive and Critical Care Societies, WFPICCS 2018. Singapore. 19 (6 Supplement 1) (pp 41)-9th Congress of the World Federation of Pediatric Intensive and Critical Care Societies, WFPICCS 2018. Singapore. 19 (6 Supplement 1) (pp 41)

Volume

Conference

Collection

Citation

Sidgwick P;Du Pre P;Skellett S, “Talking to families when death becomes a likely outcome-a pilot simulation programme to improve end of life conversations during and around PICU admission,” Pediatric Palliative Care Library, accessed October 23, 2021, https://pedpalascnetlibrary.omeka.net/items/show/15626.

Social Bookmarking