BMC palliative care · 2025
A multidisciplinary quality improvement initiative to improve neonatal end-of-life care in a level IV NICU.
СтатьяНазвание и аннотация: Перевод в очереди
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Lofgren Hanna, Lentin Samantha, DiMatteo Anna, Pasquale Erin, Salant Jennifer, Tiwari Priyanka
Аннотация
BACKGROUND: Palliative care interventions are underutilized in infants due to a knowledge deficit among providers surrounding neonatal end-of-life care and a pervasive lack of guidelines in neonatal intensive care units (NICUs). The aim of this study was to increase end-of-life symptom management by 50% and improve staff attitude scores and awareness of end-of-life cases by 20% by August 2024.
METHODS: The Model for Improvement was used to examine the baseline of mortalities and test interventions to increase analgesia administration and improve staff attitude scores and awareness during end-of-life care.
RESULTS: Fentanyl equivalent administration in the 24 h preceding death increased by 309% between epochs. A comparison of survey responses across epochs revealed a significant increase in staff comfort, confidence, preparedness, and awareness when providing end-of-life care.
CONCLUSION: The creation of a multidisciplinary quality improvement (QI) team, the implementation of end-of-life guidelines, electronic health record (EHR) modifications, and staff education improved symptom management, staff attitude scores, and awareness when providing end-of-life care.
METHODS: The Model for Improvement was used to examine the baseline of mortalities and test interventions to increase analgesia administration and improve staff attitude scores and awareness during end-of-life care.
RESULTS: Fentanyl equivalent administration in the 24 h preceding death increased by 309% between epochs. A comparison of survey responses across epochs revealed a significant increase in staff comfort, confidence, preparedness, and awareness when providing end-of-life care.
CONCLUSION: The creation of a multidisciplinary quality improvement (QI) team, the implementation of end-of-life guidelines, electronic health record (EHR) modifications, and staff education improved symptom management, staff attitude scores, and awareness when providing end-of-life care.