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What Does the Staff Think?: Factors Associated With Clinical Staff Perceptions of What Constitutes High-Quality Dying and Death at a Tertiary Pediatric Hospital

Bennett, Rebecca MS, RN, FNP/PPCNP-BC; Proudfoot, James MSc

Journal of Hospice & Palliative Nursing: October 2016 - Volume 18 - Issue 5 - p 470–476
doi: 10.1097/NJH.0000000000000278
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In an effort to improve the care of a dying child in the hospital, research was conducted to identify factors associated with the staff's perception of high-quality dying and death. The research used a unique electronic survey that was administered to clinical staff caring for children within the final 3 days of their life in the hospital. Positive death experiences were associated with absence of patient pain, dyspnea, anxiety, or agitation and the presence of spiritual, psychological, and culturally appropriate care for the patient and family. A positive correlation with quality was noted if there was clarity about goals of care and appropriate directives were in place to alleviate suffering. When clinicians felt their needs were met and they had more end-of-life education, they also perceived the quality of the experience as higher and had less distress from the event. Variability in perceived quality of the death experience was noted between different units of the hospital. Providing a supportive environment for pediatric deaths is enhanced by ensuring certain processes are in place and clinicians have the education and support to deliver high-quality care at the end of life.

Rebecca Bennett, MS, RN, FNP/PPCNP-BC, is nurse practitioner, Acute Pain Service/Palliative Care Team, Rady Children's Hospital, San Diego, California.

James Proudfoot, MSc, is biostatistician, Clinical and Translational Research Institute, University of California, San Diego, California.

Address correspondence to Rebecca Bennett, MS, RN, FNP/PPCNP-BC, Acute Pain Service/Palliative Care Team, Rady Children's Hospital, 3020 Children's Way, San Diego, CA 92115 (rbennett@rchsd.org).

The Clinical and Translational Research Institute is partially supported by the National Institutes of Health, grant UL1TR001442 of Clinical and Translational Science Award funding.

The authors have no conflicts of interest to disclose.

© 2016 by The Hospice and Palliative Nurses Association.