Related Experiment Videos
Family involvement in end-of-life care in a paediatric intensive care unit
Jennifer V Longden1, Anton-Paul T Mayer
1Paediatric Intensive Care Unit, Sheffield Children's Hospital, Western Bank, Sheffield, UK. jenny.stent@sch.nhs.uk
Insights
Providing end-of-life care (ELC) at home for children in the paediatric intensive care unit (PICU) empowers families. This child-centered approach allows children to die in familiar surroundings, respecting parental wishes for time and place of death.
Area of Science:
- Pediatric Intensive Care Medicine
- Palliative Care
- Family-Centered Care
Background:
- End-of-life care (ELC) in a pediatric intensive care unit (PICU) is complex and emotionally challenging.
- Many children die in the PICU, often after withdrawal of life-sustaining treatment.
- There is an increasing focus on incorporating parental preferences regarding the timing and location of intensive care withdrawal.
Purpose of the Study:
- To explore the feasibility and implications of withdrawing intensive care distant from the PICU environment.
- To highlight the importance of child-centered end-of-life care that respects parental involvement.
- To present case reviews of pediatric patients receiving ELC outside the traditional PICU setting.
Main Methods:
- Retrospective case review of patients who underwent withdrawal of intensive care.
- Analysis of care provided over a 12-month period.
- Examination of challenges and considerations for home-based ELC.
Main Results:
- Successful withdrawal of intensive care and ELC occurred outside the PICU in reviewed cases.
- Home care facilitated a child-centered death in familiar surroundings.
- Parental empowerment in decision-making regarding time and place of death was a key outcome.
Conclusions:
- Withdrawing intensive care distant from the PICU is a viable and valuable component of pediatric end-of-life care.
- Home-based ELC respects the pivotal role of parents and enhances the dying child's experience.
- This approach underscores the ethos of compassionate and individualized care in the PICU.
Abstract:
End-of-life care (ELC) on a paediatric intensive care unit (PICU) is a fundamental aspect of clinical practice and yet often remains a highly emotive and challenging issue. Every year, many children die in PICU often following the withdrawal of life-sustaining treatment, and as health professionals we have a duty to provide ELC that meets the needs of the dying child and their family. To achieve this, there is a growing emphasis on incorporating parental views on withdrawal of intensive care especially in time and place. Home care of the dying child enables the child to die at home in familiar surroundings and with the people who love them the most. This service is essentially child centred and acknowledges the unique and pivotal position that parents have in their child's life by empowering them to have control over the time and place of death. This is a vitally important aspect of end-of-life in PICU and underpins the ethos of this area of practice. We present a series of case reviews of patients cared for within a 12-month period, where intensive care was withdrawn distant from the PICU environment and address the challenges and considerations surrounding this area of practice.
Related Concept Videos
01:25Continuing Care
01:27Ethical Issues
Ethical Concerns in Healthcare:
01:27Nursing Ethical Principles II
Consider the following scenario, which illustrates how these principles are applied in the care of Mr. John, a fifty-year-old teacher diagnosed with metastatic liver cancer.
Initially, Mr. John's cancer...
01:30Ethical Dilemmas II
01:17Endotracheal Intubation II: Nursing Management
1. Nursing Care of Patients Before Intubation
Before the endotracheal intubation procedure, nurses play an essential role in ensuring the process goes smoothly. The nurses must be familiar with intubation...
01:21Interdisciplinary Care: The Health Care Team-I
Physicians
The physician's primary responsibility is to diagnose illness and direct the medical or surgical treatment of the condition. The authority to admit patients to a healthcare agency or institution and practice care within that setting is granted to physicians by the healthcare agency or institution itself.