Publication
Utilization of a prenatal palliative care consultation pathway for congenital heart disease
Mikal M, Gandhi R, Walsh S · Cardiology in the Young · 2024
Background: A large Midwestern hospital has no consistent process for prenatal integration of palliative care for parents carrying a fetus diagnosed with complex congenital heart disease. The palliative care team is typically consulted postnatally when infants' anomalies are severe or post-operative trajectories are prolonged. Early palliative care enhances emotional, psychosocial, and spiritual support while providing an interprofessional approach to care. Understanding pediatric cardiac provider attitudes, knowledge, and patterns of prenatal palliative care consultation for fetus' with complex heart disease will guide practice change toward increased prenatal consultation. Method(s): A retrospective database review identified 21.5% of patients would have qualified for prenatal palliative care consultation. A pathway for consultation was developed. A pre-evaluation of pediatric cardiac provider attitudes regarding palliative care was measured. Survey data informed educational material development which was then presented to pediatric cardiac providers. The number of prenatal palliative care consults were tracked. A post survey was completed by the pediatric cardiac providers. Result(s): Provider competency in symptom management, communication, timing of palliative care involvement, and barriers to palliative care consultation were examined. Most respondents had no formal training in palliative care. Training in psychological distress of parents and patients was highly ranked as needed. Providers greatest obstacle for referral was their impression that palliative care implied they were giving-up on the infant's survival. They learned utilization of palliative care is for comfort and support, not preparation for death. Conclusion(s): As providers become more knowledgeable about early integration of palliative care, parents, and infants will benefit greatly from referrals and initiation of palliative care at the time of diagnosis.
Synced from the TRENDS in Pediatric Palliative Care Zotero library, curated by The Siden Research Team. ICPCN does not host or verify the full text.