Title

Integrating Palliative Care into the PICU: A Report from the Improving Palliative Care in the ICU Advisory Board.

Authors

Renee Boss MD, Division of Neonatology, Department of Pediatrics, John Hopkins University of Medicine
Judith Nelson MD, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai
David Weissman MD, Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai
Margaret Campbell PhD, RN, Center to Advance Palliative Care, Icahn School of Medicine at Mount Sinai, New York, NY.
Randall Curtis MD, Center for Health Research, College of Nursing, Wayne State University, Detroit, MI.
Jennifer Frontera MD, Division of Pulmonary Care and Critical Care Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA.
Michelle Gabriel RN, Division of Pulmonary Care and Critical Care Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA
Dana R. Lustbader MD, Cerebrovascular Center, Cleveland Clinic, Cleveland, OH.Follow
Anne Mosenthal MD, VA Palo Alto Health Care System, Palo Alto, CA.
Colleen Mulkerin MSW, Section of Palliative Care, North Shore-Long Island Jewish Health System, Manhasset NY
Kathleen Puntillo PhD, RN, Department of Surgery, New Jersey Medical School-University of Medicine and Dentistry of New Jersey, Newark, NJ.
Daniel Ray MD, Hartford Hospital, Hartford, CT.
Rick Bassett MSN, Department of Physiological Nursing, University of California, San Francisco, CA.Follow
Karen Brasel MD, Lehigh Valley Health Network, Allentown, PA.
Ross Hays MD, Center for Health Research, College of Nursing, Wayne State University, Detroit, MI.

Publication/Presentation Date

10-1-2014

Abstract

OBJECTIVE: This review highlights benefits that patients, families and clinicians can expect to realize when palliative care is intentionally incorporated into the PICU.

DATA SOURCES: We searched the MEDLINE database from inception to January 2014 for English-language articles using the terms "palliative care" or "end of life care" or "supportive care" and "pediatric intensive care." We also hand-searched reference lists and author files and relevant tools on the Center to Advance Palliative Care website.

STUDY SELECTION: Two authors (physicians with experience in pediatric intensive care and palliative care) made final selections.

DATA EXTRACTION: We critically reviewed the existing data and tools to identify strategies for incorporating palliative care into the PICU.

DATA SYNTHESIS: The Improving Palliative Care in the ICU Advisory Board used data and experience to address key questions relating to: pain and symptom management, enhancing quality of life, communication and decision-making, length of stay, sites of care, and grief and bereavement.

CONCLUSIONS: Palliative care should begin at the time of a potentially life-limiting diagnosis and continue throughout the disease trajectory, regardless of the expected outcome. Although the PICU is often used for short term postoperative stabilization, PICU clinicians also care for many chronically ill children with complex underlying conditions and others receiving intensive care for prolonged periods. Integrating palliative care delivery into the PICU is rapidly becoming the standard for high quality care of critically ill children. Interdisciplinary ICU staff can take advantage of the growing resources for continuing education in pediatric palliative care principles and interventions.

Volume

15

Issue

8

First Page

762

Last Page

767

ISSN

1529-7535

Disciplines

Medical Sciences | Medicine and Health Sciences | Nursing

PubMedID

25080152

Department(s)

Department of Medicine, Section of Palliative Medicine and Hospice

Document Type

Article