Legacy at the Bedside: A Nurse-Led Evidence-Based Framework for Memory-Making in the Pediatric Intensive Care Unit

Area of Science:

• Pediatric Palliative Care
• Pediatric Critical Care
• Bereavement Studies

Background:

• Families in the pediatric intensive care unit (PICU) experience sudden loss and overwhelming decisions.
• Memory-making offers connection and keepsakes but bedside teams lack clear guidance.
• Existing literature lacks a structured framework for implementing memory-making in the PICU.

Purpose of the Study:

• To synthesize evidence from pediatric palliative care, bereavement, and critical care literature.
• To develop a nurse-led, evidence-based framework for memory-making in the PICU.
• To guide interdisciplinary teams in offering memory-making compassionately.

Main Methods:

• Literature synthesis of pediatric palliative care, bereavement, and critical care.
• Development of the LEGACY-PICU framework.
• Identification of PICU-specific actions for memory-making.

Main Results:

• The LEGACY-PICU framework provides a structured, flexible approach: Listening, Explaining, Guiding, Acknowledging, Creating, Yielding.
• PICU-specific actions include supply preparation, interdisciplinary team integration, and timing coordination.
• The framework aims to unburden staff through role clarity and debriefing.

Conclusions:

• The LEGACY-PICU framework supports nurses and teams in offering memory-making as a compassionate invitation.
• Implementing memory-making can enhance family connection and coping during end-of-life care in the PICU.
• A structured yet flexible approach is crucial for successful integration of memory-making practices.