Integrating palliative care into the PICU

A report from the improving palliative care in the ICU advisory board

Renee Boss, Judith Nelson, David Weissman, Margaret Campbell, Randall Curtis, Jennifer Frontera, Michelle Gabriel, Dana Lustbader, Anne Mosenthal, Colleen Mulkerin, Kathleen Puntillo, Daniel Ray, Rick Bassett, Karen Brasel, Ross Hays

Research output: Contribution to journalArticle

18 Citations (Scopus)

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 pal- liative care principles and interventions. (Pediatr Crit Care Med 2014; 15:762-767).

Original languageEnglish (US)
Pages (from-to)762-767
Number of pages6
JournalPediatric Critical Care Medicine
Volume15
Issue number8
DOIs
StatePublished - Oct 10 2014

Fingerprint

Palliative Care
Critical Care
Pediatrics
Hospice Care
Terminal Care
Grief
Quality of Health Care
Information Storage and Retrieval
Continuing Education
Pain Management
Critical Illness
MEDLINE
Length of Stay
Decision Making
Chronic Disease
Language
Communication
Quality of Life
Databases
Physicians

All Science Journal Classification (ASJC) codes

  • Critical Care and Intensive Care Medicine
  • Pediatrics, Perinatology, and Child Health

Cite this

Boss, Renee ; Nelson, Judith ; Weissman, David ; Campbell, Margaret ; Curtis, Randall ; Frontera, Jennifer ; Gabriel, Michelle ; Lustbader, Dana ; Mosenthal, Anne ; Mulkerin, Colleen ; Puntillo, Kathleen ; Ray, Daniel ; Bassett, Rick ; Brasel, Karen ; Hays, Ross. / Integrating palliative care into the PICU : A report from the improving palliative care in the ICU advisory board. In: Pediatric Critical Care Medicine. 2014 ; Vol. 15, No. 8. pp. 762-767.
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Boss, R, Nelson, J, Weissman, D, Campbell, M, Curtis, R, Frontera, J, Gabriel, M, Lustbader, D, Mosenthal, A, Mulkerin, C, Puntillo, K, Ray, D, Bassett, R, Brasel, K & Hays, R 2014, 'Integrating palliative care into the PICU: A report from the improving palliative care in the ICU advisory board', Pediatric Critical Care Medicine, vol. 15, no. 8, pp. 762-767. https://doi.org/10.1097/PCC.0000000000000209

Integrating palliative care into the PICU : A report from the improving palliative care in the ICU advisory board. / Boss, Renee; Nelson, Judith; Weissman, David; Campbell, Margaret; Curtis, Randall; Frontera, Jennifer; Gabriel, Michelle; Lustbader, Dana; Mosenthal, Anne; Mulkerin, Colleen; Puntillo, Kathleen; Ray, Daniel; Bassett, Rick; Brasel, Karen; Hays, Ross.

In: Pediatric Critical Care Medicine, Vol. 15, No. 8, 10.10.2014, p. 762-767.

Research output: Contribution to journalArticle

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T2 - A report from the improving palliative care in the ICU advisory board

AU - Boss, Renee

AU - Nelson, Judith

AU - Weissman, David

AU - Campbell, Margaret

AU - Curtis, Randall

AU - Frontera, Jennifer

AU - Gabriel, Michelle

AU - Lustbader, Dana

AU - Mosenthal, Anne

AU - Mulkerin, Colleen

AU - Puntillo, Kathleen

AU - Ray, Daniel

AU - Bassett, Rick

AU - Brasel, Karen

AU - Hays, Ross

PY - 2014/10/10

Y1 - 2014/10/10

N2 - 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 pal- liative care principles and interventions. (Pediatr Crit Care Med 2014; 15:762-767).

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