Introduction/Background/Significance
Palliative care nurses know how to care for the dying, yet care of the dying child or baby feels different. Many clinicians feel less sure about the medications and ensuring comfort to a child in the last days of life and how to support the family.
Aims/Objectives/Hypothesis/Goals or Problem
The Last Days of Life: Paediatric and Neonatal Toolkit (LDOL: P&N) was developed to provide best practice guidance in the care of a dying neonate and child.
Approach/Methods/Procedure
Consisting of eight documents, including medication guidance documents and a symptom assessment chart, this resource offers education and a standardised approach to holistic patient care for clinicians working in acute care settings. The LDOL: P&N has been informed and tested through seven paediatric and neonatal simulation scenarios, consumer feedback, and a six month quality improvement pilot. Clinicians’ feedback was obtained through an online survey or semi-structured interviews. Nine sites were involved in the pilot.
Results/Findings/Outcomes
The LDOL: P&N commenced on 12 occasions during the six month Pilot. Twenty-five staff volunteered feedback which identified that the LDOL: P&N; ‘helped with language,’ ‘provided prompts for symptom assessment,’ ‘helped to know where to put focus,’ ‘documented and time-stamped so we knew when things happened,’ ‘felt more confident as it confirmed that I was doing the right thing’ and ‘helped to standardise so that people all worked the same way.’
Discussion/Implications for practice
Palliative Care teams are well versed in the care of the dying; however, the care of a dying child presents different challenges. The LDOL: P&N guides less experienced clinicians and reassurance for the experienced when caring for a dying child or neonate. Feedback from the Pilot demonstrates the LDOL: P&N empowers, reassures, and improves confidence.
Conclusion
LDOL: P&N was identified as a valuable resource that increased clinicians’ confidence and changed the focus of care to support best practices.
Conflict of interest - No conflict of interest
Funding acknowledgment - The LDOL: P&N Pilot was sponsored by the NSW Ministry of Health: Palliative Care Flexible Funding Initiative