Mrs Gail Mcglinn1, Linda Mortimer2, David Corden3
1Nepean Blue Mountains Local Health District, Katoomba, Australia, 2Nepean Blue Mountains Local Health District, Katoomba, Australia, 3Nepean Blue Mountains Local Health District, Katoomba, Australia
Biography:
Gail has worked in palliative care for many years. Personal experience has offered Gail the opportunity to reflect on how interactions with medical and nursing staff can influence the wellbeing of families when they are faced with the imminent death of their loved one. This has fostered a great need to ensure that families and carers are at the core of the decision-making process when end of life is being discussed and prepared for. It is imperative that those close to the patient are well informed and well prepared for what lies ahead, and that the patients voice is heard.
Abstract:
Background:
Paediatric end-of-life care (EOLC) is a specialty service not usually provided by the children’s ward at Blue Mountains Hospital. Within the local community a child was receiving palliative care at home and at the request of the family a parallel plan was developed for hospital based EOLC as a secondary option.
Aim:
To develop and deliver an education strategy to foster and enhance the confidence and capability of inpatient paediatric nurses/midwives in delivering high quality EOLC.
Methods:
The palliative care CNC and Paediatric education team collaborated with the Primary Care Community Health Palliative Care Team and the Children’s Hospital Westmead Palliative Outreach Support team to develop and deliver tailored education and support following the Essential Elements for Safe and High-Quality Paediatric End of Life Care Framework. This framework enabled the team to identify key elements to support staff to safely deliver high quality EOLC to paediatric patients. Initiatives included pre-briefing with staff to identify their concerns and educational needs, psychosocial support, coordinated care planning, clinical skills training on CVAD access, subcutaneous infusion, use of the last days of life toolkit, care of the deceased child and post death debrief sessions.
Results:
The education strategy and collaborative planning supported the development of high-quality, family-centred EOLC and a respectful, efficient hospital admission process. The family were able to fulfil their child’s wish to die at home and later expressed gratitude to the paediatric team for the open collaboration and the establishment of a direct admission pathway and care plan should they have needed it.
Conclusion:
The staff reported improved confidence and reduced anxiety in providing paediatric EOLC and the ward manager reported enhanced team cohesion and emotional well-being.