Implementing palliative care, based on family-centered care, in a highly complex neonatal unit
Objective: To describe the causes and circumstances of neonatal mortality and determine whether the implementation of a palliative care protocol has improved the quality of end-of-life care. Methods: A retrospective observational study including all patient mortalities between January 2009 and Decem...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-03-01
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| Series: | Jornal de Pediatria |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0021755723001250 |
| _version_ | 1827322377364570112 |
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| author | Ana Morillo Palomo Jordi Clotet Caba Marta Camprubí Camprubí Elena Blanco Díez Joel Silla Gil Ana Riverola de Veciana |
| author_facet | Ana Morillo Palomo Jordi Clotet Caba Marta Camprubí Camprubí Elena Blanco Díez Joel Silla Gil Ana Riverola de Veciana |
| author_sort | Ana Morillo Palomo |
| collection | DOAJ |
| description | Objective: To describe the causes and circumstances of neonatal mortality and determine whether the implementation of a palliative care protocol has improved the quality of end-of-life care. Methods: A retrospective observational study including all patient mortalities between January 2009 and December 2019. Cause of death and characteristics of support during the dying process were collected. Two periods, before and after the implementation of a palliative care protocol, were compared. Results: There were 344 deaths. Congenital malformations were the most frequent cause of death (45.6 %). Most patients died after the transition to palliative care (74.4 %). The most frequently cited criteria for initiating transition of care was poor neurocognitive prognosis (47.2 %). Parents accompanied their children in the dying process in 72 % of cases. Twenty-three percent of patients died outside the Neonatal Intensive Care Unit after being transferred to a private room to enhance family intimacy. After the addition of the palliative care protocol, statistically significant differences were observed in the support and patient experience during the dying process. Conclusions: The most frequent causes of death were severe congenital malformations. Most patients died accompanied by their parents after the transition to palliative care. The implementation of a palliative care protocol helped to improve the family-centered end-of-life care. |
| first_indexed | 2024-04-25T01:23:36Z |
| format | Article |
| id | doaj.art-5dfc760d16624b3e93be4e11c5c177ce |
| institution | Directory Open Access Journal |
| issn | 0021-7557 |
| language | English |
| last_indexed | 2024-04-25T01:23:36Z |
| publishDate | 2024-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Jornal de Pediatria |
| spelling | doaj.art-5dfc760d16624b3e93be4e11c5c177ce2024-03-09T09:23:58ZengElsevierJornal de Pediatria0021-75572024-03-011002143148Implementing palliative care, based on family-centered care, in a highly complex neonatal unitAna Morillo Palomo0Jordi Clotet Caba1Marta Camprubí Camprubí2Elena Blanco Díez3Joel Silla Gil4Ana Riverola de Veciana5Corresponding author.; Sant Joan de Déu Barcelona Children's Hospital, Neonatal Intensive Care Unit, Barcelona, SpainSant Joan de Déu Barcelona Children's Hospital, Neonatal Intensive Care Unit, Barcelona, SpainSant Joan de Déu Barcelona Children's Hospital, Neonatal Intensive Care Unit, Barcelona, SpainSant Joan de Déu Barcelona Children's Hospital, Neonatal Intensive Care Unit, Barcelona, SpainSant Joan de Déu Barcelona Children's Hospital, Neonatal Intensive Care Unit, Barcelona, SpainSant Joan de Déu Barcelona Children's Hospital, Neonatal Intensive Care Unit, Barcelona, SpainObjective: To describe the causes and circumstances of neonatal mortality and determine whether the implementation of a palliative care protocol has improved the quality of end-of-life care. Methods: A retrospective observational study including all patient mortalities between January 2009 and December 2019. Cause of death and characteristics of support during the dying process were collected. Two periods, before and after the implementation of a palliative care protocol, were compared. Results: There were 344 deaths. Congenital malformations were the most frequent cause of death (45.6 %). Most patients died after the transition to palliative care (74.4 %). The most frequently cited criteria for initiating transition of care was poor neurocognitive prognosis (47.2 %). Parents accompanied their children in the dying process in 72 % of cases. Twenty-three percent of patients died outside the Neonatal Intensive Care Unit after being transferred to a private room to enhance family intimacy. After the addition of the palliative care protocol, statistically significant differences were observed in the support and patient experience during the dying process. Conclusions: The most frequent causes of death were severe congenital malformations. Most patients died accompanied by their parents after the transition to palliative care. The implementation of a palliative care protocol helped to improve the family-centered end-of-life care.http://www.sciencedirect.com/science/article/pii/S0021755723001250Neonatal deathNeonatal intensive care unitFamily-centered careRedirection of careNeonatal palliative care |
| spellingShingle | Ana Morillo Palomo Jordi Clotet Caba Marta Camprubí Camprubí Elena Blanco Díez Joel Silla Gil Ana Riverola de Veciana Implementing palliative care, based on family-centered care, in a highly complex neonatal unit Jornal de Pediatria Neonatal death Neonatal intensive care unit Family-centered care Redirection of care Neonatal palliative care |
| title | Implementing palliative care, based on family-centered care, in a highly complex neonatal unit |
| title_full | Implementing palliative care, based on family-centered care, in a highly complex neonatal unit |
| title_fullStr | Implementing palliative care, based on family-centered care, in a highly complex neonatal unit |
| title_full_unstemmed | Implementing palliative care, based on family-centered care, in a highly complex neonatal unit |
| title_short | Implementing palliative care, based on family-centered care, in a highly complex neonatal unit |
| title_sort | implementing palliative care based on family centered care in a highly complex neonatal unit |
| topic | Neonatal death Neonatal intensive care unit Family-centered care Redirection of care Neonatal palliative care |
| url | http://www.sciencedirect.com/science/article/pii/S0021755723001250 |
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