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The Benefits of a Nurse-Driven, Patient- and Family-Centered Pediatric Palliative Care Program

Kari A Mastro1, Joyce E Johnson, Nicole McElvery

  • 1Author Affiliations: Vice President, Nursing and Patient Care Services, Morgan Stanley Children's Hospital at New York Presbyterian, and Clinical Professor, Columbia University, New York (Ms Mastro); Associate Professor, The Catholic University of America School of Nursing, Washington, DC, and Emeriti Associate Dean and Clinical Professor, Rutgers University School of Nursing, Newark, and Emeriti Senior Vice President & Chief Nursing Officer, Robert Wood Johnson University Hospital, New Brunswick, New Jersey (Dr Johnson); Patient Care Director, Pediatric Hematology, Oncology, Bone Marrow Transplant, Morgan Stanley Children's Hospital at New York Presbyterian, New York (Ms McElvery); and Adjunct Clinical Instructor,Seton Hall University, South Orange, New Jersey, and Adjunct Professor, New Jersey City University, Jersey City (Ms Preuster).

The Journal of Nursing Administration
|August 8, 2015
PubMed

Insights

A nurse-led palliative care program improved outcomes for pediatric patients by offering continuous care. This approach prevented any child deaths on ventilators in the pediatric ICU related to end-of-life issues.

Area of Science:

  • Pediatric Palliative Care
  • Healthcare Delivery Models
  • Nursing Leadership

Background:

  • Pediatric advanced comprehensive care requires a coordinated approach.
  • Existing models may not fully address the continuum of care for critically ill children.
  • Patient and family-centered care is crucial in pediatric advanced care.

Purpose of the Study:

  • To describe the program and outcomes of a nurse-driven, patient- and family-centered pediatric advanced comprehensive care team (PACCT) palliative program.
  • To evaluate the impact of this care model on patient outcomes.
  • To assess the effectiveness of PACCT in managing end-of-life care in the pediatric intensive care unit (PICU).

Main Methods:

  • Implementation of a nurse-driven palliative care program (PACCT).
  • Focus on patient- and family-centered care delivery.
  • Care coordination across the healthcare continuum for pediatric patients.

Main Results:

  • The PACCT program demonstrated improved patient outcomes.
  • The care delivery model provided comprehensive support across the healthcare continuum.
  • A significant outcome was that no child died on a ventilator in the PICU due to end-of-life issues since the program's inception.

Conclusions:

  • Nurse-driven, patient- and family-centered palliative care models can significantly improve outcomes for pediatric patients.
  • The PACCT program effectively integrated palliative care across the healthcare continuum.
  • This model has the potential to reduce end-of-life-related deaths on ventilators in the PICU.

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