1. Perinatal palliative care: a dedicated care pathway
- Author
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Franca Benini, Francesca Rusalen, Paola Lago, Maria Elena Cavicchiolo, and Sabrina Salvadori
- Subjects
Parents ,medicine.medical_specialty ,Palliative care ,Family support ,Population ,Psychological intervention ,Medicine (miscellaneous) ,Disease ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,Multidisciplinary approach ,Intensive care ,medicine ,Humans ,030212 general & internal medicine ,education ,Terminal Care ,education.field_of_study ,Shared care ,Oncology (nursing) ,business.industry ,Palliative Care ,Infant, Newborn ,Infant ,General Medicine ,Medical–Surgical Nursing ,Hospice Care ,Family medicine ,Hospice and Palliative Care Nursing ,Female ,business - Abstract
ObjectiveEnsure access to perinatal palliative care (PnPC) to all eligible fetuses/infants/parents.DesignDuring 12 meetings in 2016, a multidisciplinary work-group (WG) performed literature review (Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method was applied), including the ethical and legal references, in order to propose shared care pathway.SettingMaternal-Infant Department of Padua’s University Hospital.PatientsPnPC eligible population has been divided into three main groups: extremely preterm newborns (first group), newborns with prenatal/postnatal diagnosis of life-limiting and/or life-threatening disease and poor prognosis (second group) and newborns for whom a shift to PnPC is appropriate after the initial intensive care (third group).InterventionsThe multidisciplinary WG has shared care pathway for these three groups and defined roles and responsibilities.Main outcome measuresPrenatal and postnatal management, symptom’s treatment, end-of-life care.ResultsThe best care setting and the best practice for PnPC have been defined, as well as the indications for family support, corpse management and postmortem counselling, as well suggestion for conflicts’ mediation.ConclusionsPnPC represents an emerging field within the paediatric palliative care and calls for the development of dedicated shared pathways, in order to ensure accessibility and quality of care to this specific population of newborns.
- Published
- 2019
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