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Inpatient Pediatric Palliative Care Consult Requests and Recommendations

Kristin Carter, Jennifer Raybin, Lilliam Ambroggio

    Journal of Pediatric Health Care : Official Publication of National Association of Pediatric Nurse Associates & Practitioners
    |November 23, 2021
    PubMed

    Insights

    Pediatric palliative care (PPC) consults vary by patient location and type. Understanding these differences in PPC requests and recommendations can improve care for children.

    Area of Science:

    • Palliative Care
    • Pediatric Healthcare
    • Clinical Outcomes

    Background:

    • Pediatric palliative care (PPC) plays a crucial role in managing symptoms and supporting families of children with serious illnesses.
    • Limited data exists on the specific requests and recommendations generated by PPC consults, particularly concerning variations based on patient location or history with PPC services.

    Purpose of the Study:

    • To investigate the characteristics of PPC consult requests and recommendations.
    • To determine if these requests and recommendations differ between children in intensive care units (ICUs) versus general wards.
    • To compare PPC consults for new versus established patients.

    Main Methods:

    • A retrospective cohort study was conducted, analyzing 327 PPC encounters between January 1, 2018, and June 30, 2019.
    • Data on PPC consult requests and recommendations were compared based on patient location (ward vs. ICU) and patient type (new vs. established).
    • Bivariate statistical analyses were employed to identify significant differences.

    Main Results:

    • Symptom management was more frequently a focus in consults for ward patients compared to ICU patients.
    • Consults for new patients were initiated later in the hospital stay and more often addressed psychosocial support and goals of care compared to established patients.

    Conclusions:

    • Significant variability exists in PPC consult requests and recommendations, influenced by patient location and prior engagement with PPC services.
    • These findings highlight the need for tailored approaches and targeted education for primary providers to optimize PPC integration into pediatric care.
    Abstract

    Keywords:
    Pediatric palliative careinpatient palliative carepalliative care consults

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