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Comfort/palliative care guidelines for neonatal practice: development and implementation in an academic medical
1Section of Neonatology, Department of Pediatrics, Medical College of Georgia, Augusta, GA, USA.
Insights
A new comfort care guideline was developed for the neonatal intensive care unit (NICU). This practical, family-centered guideline improves palliative care for newborns with life-limiting conditions and aids staff education.
Area of Science:
- Neonatal Medicine
- Palliative Care
- Healthcare Guideline Development
Background:
- Neonatal intensive care units (NICUs) require specialized guidelines for comfort care.
- Palliative care measures are crucial for infants with life-limiting conditions.
- A multidisciplinary approach is essential for developing effective NICU guidelines.
Purpose of the Study:
- To detail the development of a comfort care guideline for a NICU.
- To ensure the guideline is practical, family-centered, respectful, and educational.
- To address palliative care needs in a tertiary academic medical center.
Main Methods:
- A consensus-building process was employed.
- Involved multidisciplinary staff from NICU and Obstetrics units.
- Utilized naturalistic inquiry for development.
Main Results:
- An approved hospital guideline for comfort care was formulated and implemented over 16 months.
- The guideline specifies candidates for comfort care, location, and essential services for infant and family.
- Initial reports indicate staff acceptance and integration into trainee education.
Conclusions:
- Institutionally derived and locally implemented guidelines can provide consistent patient care.
- Comprehensive comfort care guidelines offer significant educational value for staff and trainees.
- Practical guidelines enhance palliative care for newborns with life-limiting conditions.
Objective:
To report the multidisciplinary developmental process of a comfort care guideline for the neonatal intensive care unit (NICU) addressing palliative care measures in a tertiary academic medical center. The guideline was developed to be (1) practical, (2) family-centered, (3) respectful of the infant patient, and (4) educational.
Methods:
A consensus-building process involving medical, nursing, administrative, and ancillary professional staff integral to the NICU and Obstetrics units using naturalistic inquiry.
Results:
An approved hospital guideline was formulated and implemented over a 16-month period. It described candidates for comfort care, the locale for such care to be rendered, and the construct of essential services to the infant and family. Early reports attest to staff acceptance and it is currently incorporated into trainee education.
Conclusion:
Clinically practical guidelines, comprehensive in their scope of providing comfort care to newborns with life-limiting conditions, can be institutionally derived and locally implemented for both consistency in patient care and educational value for staff and trainees.