Utilization of a Prenatal Palliative Care Consultation Pathway for Congenital Heart Disease

Title

Utilization of a Prenatal Palliative Care Consultation Pathway for Congenital Heart Disease

Creator

Mikal M; Gandhi R; Walsh SM

Publisher

Journal of Hospice and Palliative Nursing

Date

2023

Subject

Heart Defects; Congenital; Palliative Care; Child; Female; Heart Defects; Congenital Diagnosis; Heart Defects; Congenital Therapy; Human; Infant; Palliative Care; Palliative Care Psychology; Parents Psychology; Pregnancy; Referral and Consultation; Retrospective Study

Description

Abstract
Over 4 decades, short- and long-term survival for children with congenital heart disease (CHD) has significantly increased. Those with complex CHD have a 1-year mortality rate of approximately 25%. Prenatal access to palliative care ensures a comprehensive approach to the infant's physical, emotional, spiritual, and psychosocial well-being and offers enhanced support for parents and families while providing an interprofessional approach to care. Pediatric cardiac provider attitudes, knowledge, patterns of prenatal palliative care, and consultation for fetuses with complex heart disease to guide increased and appropriate prenatal consultation were explored for a quality improvement project completed at a single institution. A retrospective cardiac database review identified that 21.5% of maternal patients seen prenatally and carrying a fetus with complex CHD would have qualified for prenatal palliative care consultation. To increase prenatal palliative care consultation, a pathway for referral was developed. A pre-evaluation of pediatric cardiac provider attitudes regarding palliative care was measured. Survey data informed the intervention phase of prenatal palliative care educational material development, which was presented to pediatric cardiac providers. The number of prenatal palliative care consults was tracked. A postintervention survey completed by pediatric cardiac providers showed increased understanding and utilization of palliative care for comfort and support and not just reserved for death preparation. Greater than 93% agreed or strongly agreed that they gained a better understanding of appropriate use of palliative/supportive care. As pediatric cardiac providers become more knowledgeable about early integration of palliative care, parents and infants will benefit greatly from referrals and initiation of palliative care at the time of prenatal diagnosis.

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 List 2023

Collection

Citation

Mikal M; Gandhi R; Walsh SM, “Utilization of a Prenatal Palliative Care Consultation Pathway for Congenital Heart Disease,” Pediatric Palliative Care Library, accessed May 26, 2024, https://pedpalascnetlibrary.omeka.net/items/show/18687.