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End-of-life care in a regional level IV neonatal intensive care unit after implementation of a palliative care initiative

Journal of Perinatology volume 35, pages 223–228 (2015)Cite this article

Subjects

Abstract

Objective:

We hypothesized that the implementation of a neonatal palliative care initiative will result in improved markers of end-of-life care.

Study design:

A retrospective and prospective chart review of neonatal intensive care unit deaths was performed for 24 months before, 16 months during and 24 months after the implementation of palliative care provider education and practice guidelines (n=106). Ancillary care, redirection of care, palliative medication usage and outcome meetings in the last 48 h of life and basic demographic data were compared between epochs. Parametric and nonparametric analysis was performed.

Result:

There was an increase in redirection of care and palliative medication usage and a decrease in variability of use of end-of-life interventions (P=0.012, 0.022 and <0.001).

Conclusion:

The implementation of a neonatal palliative care initiative was associated with increases in palliative interventions for neonates in their final 48 h of life, suggesting that such an initiative may enhance end-of-life care.

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Acknowledgements

We would like to thank the Women and Infants Hospital NICU Palliative Care working group for their critical input.

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Authors and Affiliations

  1. Department of Neonatology, Women and Infants Hospital, Providence, RI, USA

    C Samsel & B E Lechner

  2. Triple Board Residency Program, Brown University and Rhode Island Hospitals, Providence, RI, USA

    C Samsel

  3. Warren Alpert Medical School of Brown University, Providence, RI, USA

    B E Lechner

Authors
  1. C Samsel
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  2. B E Lechner
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Corresponding author

Correspondence to B E Lechner.

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The authors declare no conflict of interest.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Samsel, C., Lechner, B. End-of-life care in a regional level IV neonatal intensive care unit after implementation of a palliative care initiative. J Perinatol 35, 223–228 (2015). https://doi.org/10.1038/jp.2014.189

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