Impact of a palliative care program on end-of-life care in a neonatal intensive care unit.

Published

Journal Article

OBJECTIVE:Evaluate changes in end-of-life care following initiation of a palliative care program in a neonatal intensive care unit. STUDY DESIGN:Retrospective study comparing infant deaths before and after implementation of a Palliative Care Program comprised of medication guidelines, an individualized order set, a nursing care plan and staff education. RESULT:Eighty-two infants died before (Era 1) and 68 infants died after implementation of the program (Era 2). Morphine use was similar (88% vs 81%; P =0.17), whereas benzodiazepines use increased in Era 2 (26% vs 43%; P=0.03). Withdrawal of life support (73% vs 63%; P=0.17) and do-not-resuscitate orders (46% vs 53%; P=0.42) were similar. Do-not-resuscitate orders and family meetings were more frequent among Era 2 infants with activated palliative care orders (n=21) compared with infants without activated orders (n=47). CONCLUSION:End-of-life family meetings and benzodiazepine use increased following implementation of our program, likely reflecting adherence to guidelines and improved communication.

Full Text

Duke Authors

Cited Authors

  • Younge, N; Smith, PB; Goldberg, RN; Brandon, DH; Simmons, C; Cotten, CM; Bidegain, M

Published Date

  • March 2015

Published In

Volume / Issue

  • 35 / 3

Start / End Page

  • 218 - 222

PubMed ID

  • 25341195

Pubmed Central ID

  • 25341195

Electronic International Standard Serial Number (EISSN)

  • 1476-5543

International Standard Serial Number (ISSN)

  • 0743-8346

Digital Object Identifier (DOI)

  • 10.1038/jp.2014.193

Language

  • eng