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Continuing care describes the variety of health, personal, and social services provided over a prolonged period. The need for continuing care is increasing because people are living longer. Many people do not have families or others to care for them. Continuing care is mainly for patients who are disabled, functionally dependent, or suffering from a terminal disease. It is available within institutional settings or in homes. Examples include nursing centers or facilities, assisted living,...
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  11. A Quality Improvement Approach To Perinatal Palliative Care: Using Standardized Criteria And Education To Increase Early Nicu Palliative Care Consultation

A Quality Improvement Approach to Perinatal Palliative Care: Using Standardized Criteria and Education to Increase Early NICU Palliative Care Consultation

Emily Rosenstein1, Jan Wilson, Sofia Perazzo

  • 1Author Affiliations: Department of Neonatology, Children's National Hospital, USA (Drs Rosenstein and Perazzo); University of Maryland School of Nursing, USA (Dr Wilson); and Department of Pediatrics, George Washington University School of Medicine and Health Sciences, USA (Dr Perazzo).

Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses
|December 31, 2025

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A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
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View abstract on PubMed

Summary
This summary is machine-generated.

Implementing standardized criteria and education significantly improved perinatal palliative care (PC) consults for infants in a neonatal intensive care unit (NICU). This enhanced care quality for high-risk infants and their families.

Area of Science:

  • Neonatal Intensive Care Unit (NICU) Care
  • Palliative Care (PC)
  • Quality Improvement Projects

Background:

  • Perinatal palliative care (PC) is crucial for infants with life-limiting conditions.
  • Underutilization of PC services in a Level IV NICU impacted care quality for infants and families.

Purpose of the Study:

  • To increase early PC consults for eligible NICU infants from 33% to 100% between August and December 2022.
  • Enhance the quality of care for infants with chronic critical conditions.

Main Methods:

  • Utilized the Promoting Action on Research Implementation in Health Services (PARIHS) framework.
  • Implemented standardized diagnostics, prenatal referrals, and eligibility criteria in one NICU.
  • Measured PC consult ordering compliance and provider education effectiveness.
Keywords:
guidelineneonatalpalliative careprotocol

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Main Results:

  • PC consult ordering compliance increased from 33% to 100% within two weeks and was sustained.
  • Time from NICU admission to PC consult order decreased from 40 to 15.5 days.
  • Provider education improved clinician comfort in identifying eligible infants (Z=3.02, P=.003).

Conclusions:

  • Standardized eligibility criteria and staff education effectively improved early PC consult ordering in the NICU.
  • This quality improvement initiative enhanced care delivery for critically ill infants and their families.
quality improvement
referral criteria
trigger