scholarly journals Knowing nursing team care practices in relation to newborns in end-of-life situations

2017 ◽  
Vol 21 (4) ◽  
Author(s):  
Isabella Navarro Silva ◽  
Natália Rejane Salim ◽  
Regina Szylit ◽  
Patricia Stella Silva Sampaio ◽  
Carolliny Rossi de Faria Ichikawa ◽  
...  
Keyword(s):  
End Of Life ◽  
Nursing Staff ◽  
Neonatal Intensive Care ◽  
Human Life ◽  
Neonatal Intensive Care Units ◽  
End Of Life Decisions ◽  
Team Care ◽  
Care Practices ◽  
Care Relationships ◽  
Nursing Professionals

Abstract Objective: Understand the care practices experiences of nursing staff in relation to providing end-of-life care to newborns and their families in neonatal intensive care units (NICU). Method: Descriptive study with a qualitative approach, involving eight nursing professionals from an NICU. Results: Through the data analysis, it was possible to identify three central themes: the "obscurity of death in neonatal ICUs": coping with death at the onset of a human life; palliative care and end-of-life decisions: the challenges faced by nursing staff in neonatal ICUs; and types of nursing care in the daily activities of neonatal ICUs. Conclusion: It is essential to understand the experiences and needs of nursing staff, so that proposals can be formulated for seeking improvements in the care relationships that take place in this context.

A descriptive report of end-of-life care practices occurring in two neonatal intensive care units

2016 ◽  
Vol 30 (10) ◽  
pp. 971-978 ◽  
Author(s):  
Vanessa Lam ◽  
Nicole Kain ◽  
Chloe Joynt ◽  
Michael A van Manen
Keyword(s):  
Congenital Anomaly ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
End Of Life ◽  
End Of Life Care ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Life Care ◽  
Life Sustaining Treatment ◽  
Care Practices

Background: In Canada and other developed countries, the majority of neonatal deaths occur in tertiary neonatal intensive care units. Most deaths occur following the withdrawal of life-sustaining treatments. Aim: To explore neonatal death events and end-of-life care practices in two tertiary neonatal intensive care settings. Design: A structured, retrospective, cohort study. Setting/participants: All infants who died under tertiary neonatal intensive care from January 2009 to December 2013 in a regional Canadian neonatal program. Deaths occurring outside the neonatal intensive care unit in delivery rooms, hospital wards, or family homes were not included. Overall, 227 infant deaths were identified. Results: The most common reasons for admission included prematurity (53.7%), prematurity with congenital anomaly/syndrome (20.3%), term congenital anomaly (11.5%), and hypoxic ischemic encephalopathy (12.3%). The median age at death was 7 days. Death tended to follow a decision to withdraw life-sustaining treatment with anticipated poor developmental outcome or perceived quality of life, or in the context of a moribund dying infant. Time to death after withdrawal of life-sustaining treatment was uncommonly a protracted event but did vary widely. Most dying infants were held by family members in the neonatal intensive care unit or in a parent room off cardiorespiratory monitors. Analgesic and sedative medications were variably given and not associated with a hastening of death. Conclusion: Variability exists in end-of-life care practices such as provision of analgesic and sedative medications. Other practices such as discontinuation of cardiorespiratory monitors and use of parent rooms are more uniform. More research is needed to understand variation in neonatal end-of-life care.

scholarly journals Psychological support in end-of-life decision-making in neonatal intensive care units: Full population survey among neonatologists and neonatal nurses

2019 ◽  
Vol 34 (3) ◽  
pp. 430-434 ◽  
Author(s):  
Laure Dombrecht ◽  
Joachim Cohen ◽  
Filip Cools ◽  
Luc Deliens ◽  
Linde Goossens ◽  
...  
Keyword(s):  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Psychological Support ◽  
Neonatal Intensive Care Units ◽  
End Of Life Decisions ◽  
Life Decisions ◽  
End Of Life Decision ◽  
Life Decision

Background: Moral distress and burnout related to end-of-life decisions in neonates is common in neonatologists and nurses working in neonatal intensive care units. Attention to their emotional burden and psychological support in research is lacking. Aim: To evaluate perceived psychological support in relation to end-of-life decisions of neonatologists and nurses working in Flemish neonatal intensive care units and to analyse whether or not this support is sufficient. Design/participants: A self-administered questionnaire was sent to all neonatologists and neonatal nurses of all eight Flemish neonatal intensive care units (Belgium) in May 2017. The response rate was 63% (52/83) for neonatologists and 46% (250/527) for nurses. Respondents indicated their level of agreement (5-point Likert-type scale) with seven statements regarding psychological support. Results: About 70% of neonatologists and nurses reported experiencing more stress than normal when confronted with an end-of-life decision; 86% of neonatologists feel supported by their colleagues when they make end-of-life decisions, 45% of nurses feel that the treating physician listens to their opinion when end-of-life decisions are made. About 60% of both neonatologists and nurses would like more psychological support offered by their department when confronted with end-of-life decisions, and 41% of neonatologists and 50% of nurses stated they did not have enough psychological support from their department when a patient died. Demographic groups did not differ in terms of perceived lack of sufficient support. Conclusion: Even though neonatal intensive care unit colleagues generally support each other in difficult end-of-life decisions, the psychological support provided by their department is currently not sufficient. Professional ad hoc counselling or standard debriefings could substantially improve this perceived lack of support.

scholarly journals Physicians’ attitudes in relation to end-of-life decisions in Neonatal Intensive Care Units: a national multicenter survey

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Ilias Chatziioannidis ◽  
Zoi Iliodromiti ◽  
Theodora Boutsikou ◽  
Abraham Pouliakis ◽  
Evangelia Giougi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Attitude Score ◽  
End Of Life Decisions ◽  
Life Decisions

Abstract Background End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in Neonatal Intensive Care Units and correlate them with self-reported practices of end-of-life decisions and with their background data. Methods A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with a questionnaire of 12 items measuring physicians’ attitude and views ranging from value of life to quality of life approach (scale 1–5). Results Continuation of treatment in neonates with adverse prognosis without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to withdrawal of mechanical ventilation. Physicians with a high attitude score (indicative of value of quality-of-life) were more likely to limit, while those with a low score (indicative of value of sanctity-of-life) were more likely for continuation of intensive care. Physicians’ educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p < 0.001) were factors that affected the attitude score. Conclusions Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief for Greek legal system reform.

Center, Gestational Age, and Race Impact End-of-Life Care Practices at Regional Neonatal Intensive Care Units

2020 ◽  
Vol 217 ◽  
pp. 86-91.e1
Author(s):  
Jessica T. Fry ◽  
Nana Matoba ◽  
Ankur Datta ◽  
Robert DiGeronimo ◽  
Carl H. Coghill ◽  
...  
Keyword(s):  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Gestational Age ◽  
End Of Life Care ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Life Care ◽  
Care Practices

scholarly journals Physicians’ attitudes in relation to End-of-life Decisions in Neonatal Intensive Care Units: a national multicenter survey

2020 ◽  
Author(s):  
Ilias Chatziioannidis ◽  
Zoi Iliodromiti ◽  
Theodora Boutsikou ◽  
Abraham Pouliakis ◽  
Evangelia Giougi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Attitude Score ◽  
End Of Life Decisions ◽  
Life Decisions

Abstract Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in neonatal intensive care units and correlate them with self-reported practices of end-of-life decisions and with their background data. Methods: A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with a questionnaire of 12 items measuring physicians’ attitude and views ranging from value of life to quality of life approach (scale 1 to 5). Results: Continuation of treatment in neonates with adverse prognosis without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to withdrawal of mechanical ventilation. Physicians with a high attitude score (indicative of value of quality-of-life) were more likely to limit, while those with a low score (indicative of value of sanctity-of-life) were more likely for continuation of intensive care. Physicians’ educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p<0.001) were factors that affected the attitude score. Conclusions: Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief for Greek legal system reform.

scholarly journals End-of-Life Decisions in Dutch Neonatal Intensive Care Units

2009 ◽  
Vol 163 (10) ◽  
pp. 895 ◽  
Author(s):  
A. A. Eduard Verhagen ◽  
Jozef H. H. M. Dorscheidt ◽  
Bernadette Engels ◽  
Joep H. Hubben ◽  
Pieter J. Sauer
Keyword(s):  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
End Of Life Decisions ◽  
Life Decisions

scholarly journals Physicians’ Attitudes in Relation to End-of-Life Decisions in Neonatal Intensive Care Units: A National Multicenter Survey

2020 ◽  
Author(s):  
Ilias Chatziioannidis ◽  
Zoi Iliodromiti ◽  
Theodora Boutsikou ◽  
Abraham Pouliakis ◽  
Evangelia Giougi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Attitude Score ◽  
End Of Life Decisions ◽  
Life Decisions

Abstract Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in neonatal intensive care units and correlate with self-reported practices of end-of-life decisions and with their background data.Methods: A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with an attitude questionnaire of 12 items measuring physicians’ views ranging from value of life to quality of life approach (scale 1 to 5).Results: Continuation of adverse prognosis neonates treatment without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to mechanical ventilation withdrawal. Physicians with a high attitude score (indicative of quality-of-life) were more likely to limit, while a low score (indicative of sanctity-of-life) was indicative for continuation of intensive care. Physicians’ educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p<0.001) affected the attitude score.Conclusions: Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief in Greek legal system reform.

scholarly journals Physicians’ attitudes in relation to End-of-life Decisions in Neonatal Intensive Care Units: a national multicenter survey

2020 ◽  
Author(s):  
Ilias Chatziioannidis ◽  
Zoi Iliodromiti ◽  
Theodora Boutsikou ◽  
Abraham Pouliakis ◽  
Evangelia Giougi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Intensive Care ◽  
End Of Life ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Neonatal Intensive Care Units ◽  
Attitude Score ◽  
End Of Life Decisions ◽  
Life Decisions

Abstract Background: End-of-life decisions for neonates with adverse prognosis are controversial and raise ethical and legal issues. In Greece, data on physicians’ profiles, motivation, values and attitudes underlying such decisions and the correlation with their background are scarce. The aim was to investigate neonatologists' attitudes in neonatal intensive care units and correlate them with self-reported practices of end-of-life decisions and with their background data.Methods: A structured questionnaire was distributed to all 28 Neonatal Intensive Care Units in Greece. One hundred and sixty two out of 260 eligible physicians answered anonymously the questionnaire (response rate 66%). Demographic and professional characteristics, self-reported practices and opinions were included in the questionnaire, along with a questionnaire of 12 items measuring physicians’ attitude and views ranging from value of life to quality of life approach (scale 1 to 5).Results: Continuation of treatment in neonates with adverse prognosis without adding further therapeutic interventions was the most commonly reported EoL practice, when compared to withdrawal of mechanical ventilation. Physicians with a high attitude score (indicative of value of quality-of-life) were more likely to limit, while those with a low score (indicative of value of sanctity-of-life) were more likely for continuation of intensive care. Physicians’ educational level (p:0.097), involvement in research (p:0.093), religion (p:0.024) and position on the existing legal framework (p<0.001) were factors that affected the attitude score.Conclusions: Physicians presented with varying end-of-life practices. Limiting interventions in neonates with poor prognosis was strongly related to their attitudes. The most important predictors for physicians' attitudes were religiousness and belief for Greek legal system reform.

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