Pediatric Advance Care Planning: A Scoping Review

Area of Science:

• Palliative Care
• Pediatric Healthcare
• Health Services Research

Background:

• Pediatric advance care planning (pACP) is crucial for children and youth with serious illnesses.
• Current practices and documentation for pACP require assessment to inform provincial guidelines.

Purpose of the Study:

• To conduct a scoping review of the literature on pediatric advance care planning (pACP) documentation, process, and implementation.
• To identify best practices and inform the development of a provincial pACP template.

Main Methods:

• A scoping review was conducted following the Joanna Briggs Institute methodology.
• Searches included multiple databases (MEDLINE, Embase, CINAHL, Web of Science, Google Scholar) and grey literature.
• Sixty-four articles and fifteen pACP documentation tools were identified and analyzed.

Main Results:

• pACP should be a structured, collaborative, and iterative process involving families and healthcare providers, addressing medical and non-medical concerns.
• Few studies detailed specific elements for advance directive forms.
• Implementation strategies included structured interventional tools, ongoing training, mentorship, and organizational support.

Conclusions:

• No single pACP tool is considered a gold standard.
• Effective pACP relies on a combination of tools, provider education, communication skills, standardized documentation, and quality improvement support.