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Neonatal palliative care: a practical checklist approach

Naomi Taylor1, Yi Fan Liang1, Robert Tinnion2

  • 1Department of paediatrics, James Cook University Hospital, Middlesbrough, UK.

BMJ Supportive & Palliative Care
|September 19, 2018
PubMed

Insights

Regional checklists improved some neonatal palliative care aspects, including pain relief and parent discussions. However, other support areas require further enhancement for optimal care of infants with life-limiting conditions.

Area of Science:

  • Neonatal Medicine
  • Palliative Care
  • Healthcare Quality Improvement

Background:

  • National neonatal palliative care guidance was published.
  • Regional multidisciplinary checklists were implemented to enhance care quality.
  • Focus on improving care for infants with life-limiting illnesses.

Purpose of the Study:

  • To assess the impact of regional guidance checklists on neonatal palliative care quality.
  • To evaluate improvements in care domains before and after checklist implementation.

Main Methods:

  • Case note audit conducted to examine care quality.
  • Comparison of care quality before and after the introduction of regional guidance.
  • Analysis of patient cohorts: 27 before, 10 after checklist implementation.

Main Results:

  • Checklists were associated with improvements in pain relief, comfort, monitoring, and parental discussions.
  • Enhancements observed in fluid/nutrition management, diagnostics, and treatment ceiling decisions.
  • Adherence to other parental support measures remained suboptimal.

Conclusions:

  • Regional guidance positively impacted specific areas of neonatal palliative care.
  • Suboptimal performance in certain care domains necessitates further intervention.
  • Consultation with pediatric palliative care services is recommended for comprehensive quality improvement.
Abstract

Keywords:
neonatalpaediatricspalliative care

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