Establishment of a Comfort Care Order Set in a Level IV Neonatal Intensive Care Unit to Standardize Transitional Care of Terminally Ill Infants

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Corr, Christina
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2019-05-18
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The transition of changing treatment goals for a terminally ill infant can be confusing and may lead to variability in care provided. A level IV neonatal intensive care unit (NICU) at a Midwestern children's hospital lacked a standardized order set to provide smooth, transitional care for infants at the end of life (EOL). After literature review, an order set was synthesized to deliver a multi-disciplinary approach and provide standardization of care at the end of life. Education on the order set was completed prior to implementation. Following an infant death and utilization of the order set, an evaluation of the order set was done via an online survey sent to each caregiver involved. Of the six infant deaths, there was opportunity to utilize the order set on three patients. The order set was implemented, and 100 percent of caregivers completed the survey evaluation. Implementation of the order set increased staff awareness and provided easy-to-follow, organized, and multi-disciplinary directions to EOL care. Although the order set seemingly provided a standardized approach to EOL care, there was not a large enough participant size to thoroughly evaluate the effectiveness of the order set. There is a need for standardized EOL care for dying infants in the hospital setting. Continued utilization of this order set may ensure smoother transitional care for dying infants.
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University
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