Barriers to Perinatal Palliative Care Consultation

Benini, Franca; Congedi, Sabrina; Rusalen, Francesca; Cavicchiolo, Maria Elena; Lago, Paola

doi:10.3389/fped.2020.590616

Cited by 18 publications

(19 citation statements)

References 42 publications

(46 reference statements)

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“…In fact, evidence has repeatedly shown an improvement in the clinical practice of PnPC with standardized guidelines ( 68 – 71 ). This supports the view that PnPC services can facilitate palliative care ( 34 , 63 ). In addition, our findings show that a large majority of HCPs, who disclosed not having or not knowing about a guideline at their center, expressed the need for one.…”

Section: Discussionsupporting

confidence: 82%

“…Various studies have shown impressive success and improvement in knowledge through the introduction of simulation trainings ( 59 , 60 ), multidisciplinary debriefings with external specialists, and short workshops for NICU staff ( 58 , 61 , 62 ). Further studies should be conducted on the implementation of PnPC educational measures that can reinforce support for PC ( 34 , 63 ).…”

Section: Discussionmentioning

confidence: 99%

“…The open-ended answers also suggest a difference in the nurses' and physicians' perspective with physicians frequently equating PC to EOL. Evidence shows that such misinterpretation denies patients the opportunity to appropriate treatment ( 34 ). Knowing that nurses in our study had more PC education, physicians' misinterpretation of PnPC might have led to dissatisfaction among nursing staff.…”

Section: Discussionmentioning

confidence: 99%

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National Divergences in Perinatal Palliative Care Guidelines and Training in Tertiary NICUs

et al. 2021

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Objectives: Despite established principles of perinatal palliative care (PnPC), implementation into practice has shown inconsistencies. The aim of this study was to assess PnPC services, examine healthcare professionals (HCPs) awareness and availability of PnPC guidelines, and describe HCPs satisfaction with PC and guidelines.Material and Methods: A nationwide survey was conducted in Swiss tertiary NICUs between April-November 2019. Data were examined by descriptive statistics and linear regression models.Results: Overall response rate was 54% (65% physicians; 49% nurses; 72% psychosocial staff). Half of professionals (50%) received education in PC during their medical/nursing school, whereas 36% indicated they obtained further training in PnPC at their center. PnPC guidelines were available in 4/9 centers, with 68% HCPs being aware of the guideline. Professionals who had access to a PnPC team (P = 0.001) or were part of the nursing (P = 0.003) or psychosocial staff (P = 0.001) were more likely aware of having a guideline. Twenty-eight percent indicated being satisfied with PC in their center. Professionals with guideline awareness (P = 0.025), further training (P = 0.001), and access to a PnPC team (P < 0.001) were more likely to be satisfied, whereas HCPs with a nursing background (P < 0.001) were more likely to be dissatisfied. A majority expressed the need for a PnPC guideline (80%) and further PC training (94%).Conclusion: This study reveals lacking PnPC guidelines and divergences regarding onsite opportunities for continued training across Swiss level III NICUs. Extending PnPC guidelines and training services to all centers can help bridge the barriers created by fragmented practice.

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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National Divergences in Perinatal Palliative Care Guidelines and Training in Tertiary NICUs

et al. 2021

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“…From the obtained keyword network, terms such as confidence, compassion, burnout, and education highlight the challenges and needs of health care providers. Although some of these dilemmas may be difficult to overcome in the short term, significant measures must be implemented in the future to enhance providers' confidence and competence in providing good PPC ( 32 , 33 ).…”

Section: Discussionmentioning

confidence: 99%

Bibliometric Analysis of Global Research on Perinatal Palliative Care

et al. 2022

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ObjectivesThe aim of this study was to perform a bibliometric analysis of publications related to perinatal palliative care to identify scientific output and research trends at a global level.MethodsThe Web of Science Core Collection database was searched to retrieve publications focusing on perinatal palliative care published between 2001 and 2020. All retrieved publications were identified by title and abstract for their relevance to perinatal palliative care. These eligible publications were extracted from the following data: title, abstract, year, keywords, author, organization, journal and cited literature. VOSviewer software was used to conduct bibliographic coupling, coauthorship, and cooccurrence analyses and to detect publication trends in perinatal palliative care research.ResultsA total of 114 publications concerning perinatal palliative care were included. The annual number of publications has increased dramatically in recent years. The United States has made the largest contribution to this field with the majority of publications (68, 59.6%) and citations (1,091, 70.5%) and with close collaborations with researchers in Canada, Portugal and Australia. Wool C and her institution, York College of Pennsylvania, are the respectively, most prolific author and institution in this field, publishing 18 papers (15.8%). Journal of Palliative Medicine is the leading and main journal in this field. According to the cooccurrence network analysis, five main research topics were identified: the candidates for PPC, service models and forms, framework components, parental perspectives and satisfaction, and challenges and needs of health care providers.ConclusionThe findings of this bibliometric study illustrate the current state and global trends of perinatal palliative care for the past two decades, which will help researchers determine areas of research focus and explore new directions for future research in this field.

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“…Less colleagues apply QIs “always” when compared to course attendees. This can be explained by a variety of potential factors including a lack of education or expertise ( 5 ), discomfort with PNPC ( 10 , 11 ) or any of the many barriers addressed in these findings and others ( 12 ). Only two QIs reached the highest threshold when totaled, (1) communicating with parents about priorities of care and (2) managing pain and discomfort.…”

Section: Discussionmentioning

confidence: 99%

Implementation of Quality Indicators of Perinatal/Neonatal Palliative Care One-Year Following Formal Training

Wool

Parravicini

2021

Front. Pediatr.

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Objective: The aim of this study was to measure implementation of quality indicators (QIs) of Perinatal/Neonatal Palliative Care (PNPC) as reported by participants following a one-year training course.Study Design: A cross-sectional survey mixed-method design was used to obtain data from an interdisciplinary team of professionals one year after attending a PNPC training course. A questionnaire with 32 QIs queried participants about self-reported implementation of PNPC and that of their colleagues. Descriptive and frequency data were analyzed to measure the implementation of PNPC QIs. Qualitative data were examined using content analysis.Results: Response rate was 34 of 76 (44.7%). Half of the QIs are implemented in clinical settings by course attendees more than 90% of the time, and 15 QIs are implemented between 70 and 89.9%. Colleagues within the same healthcare system applied palliative care practices less frequently than those who attended the training course. When asked if quality indicators were “always” implemented by colleagues, the average difference in scores was 36% lower. Qualitative analyses resulted in three themes that addressed changes in clinical practice, and four themes that summarized barriers in practice.Conclusion: There is high frequency of implementation of QIs by professionals who attended an evidence based PNPC training course. PNPC is implemented by the colleagues of attendees, but with less frequency. Attending evidence-based education increases clinicians' opportunities to translate quality PNPC care into clinical settings.

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Barriers to Perinatal Palliative Care Consultation

Cited by 18 publications

References 42 publications

National Divergences in Perinatal Palliative Care Guidelines and Training in Tertiary NICUs

National Divergences in Perinatal Palliative Care Guidelines and Training in Tertiary NICUs

Bibliometric Analysis of Global Research on Perinatal Palliative Care

Implementation of Quality Indicators of Perinatal/Neonatal Palliative Care One-Year Following Formal Training

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